While the Affordable Care Act has achieved a second victory before the Supreme Court and produced significant coverage gains, it might also have produced a less positive outcome: in an NBER working paper, Penn LDI colleagues Mark Pauly, Adam Leive and Scott Harrington found that a large portion of non-poor (measured by income above 138% of the poverty level) who gained coverage now have a higher financial burden and lower welfare (well-being) than when they were uninsured. The authors call this extra burden a “price of responsibility” for complying with the individual mandate to purchase coverage.

With the health insurance markets open for next year’s enrollment, Eve Campeau says she’s planning to look carefully at the fine print. Last time she shopped, she switched to a plan with a lower monthly premium, but found herself paying far more out-of-pocket for medications and doctor visits. While she might be saving money on the premium, she is reluctant to go to seek medical care because of the up-front cost.

A total of $1.23 billion in federal taxpayer dollars has now been sunk in 12 of 23 co-ops created under Obamacare that have gone out of business, representing another Obamacare failure, lawmakers say. Co-ops in Arizona and Michigan went out of business last week, adding themselves to the 10 that have already failed in Utah, Kentucky, New York, Nevada, Louisiana, Oregon, Colorado, Tennessee, South Carolina, and a co-op that served both Iowa and Nebraska.

The majority of ObamaCare’s insurance co-ops—12 of 23—have now folded, and their $1.24 billion in federal loans has all but vaporized. More will fail, nearly a million Americans may lose coverage, and now the contagion from their failures is spreading.

The Affordable Care Act’s third open enrollment season started Nov. 1, and federal officials are hoping to reach about a million people like Thomas across the country. Newark has an estimated 112,000 uninsured people, around one-third of the city’s population. It is one of five areas – along with Houston, Dallas, Chicago and Miami – where the federal government is focusing enrollment efforts. Altogether, Washington will spend more than $100 million on marketing and enrollment.