The 2015 United Auto Workers union contracts with General Motors Co., Ford Motor Co. and Fiat Chrysler Automobiles NV allow the companies to alter hourly-worker health plans if they are likely to trigger a 40% federal tax on some high-cost health-care plans. The most likely change: adding yearly deductibles for affected workers.

ObamaCare plans have substantially raised the amount of cost sharing they require for drugs. Often they don’t cover any specialty drug costs until a patient has hit their deductible. There is also the issue of the dwindling number of specialty drugs that health plans include in their formularies, and provide any coverage for. Almost all of the “Silver” plans offered under ObamaCare sport closed drug formularies, where there’s no coverage for drugs not listed on the narrow formulary lists. This means when a drug doesn’t make a health plans list, consumers are completely uncovered.

Instead of more federal regulation and subsidies, what U.S. health care needs is adoption of market principles, starting with broad empowerment of the patient-consumer. The proposals advanced in this volume would replace many counterproductive and outdated federal policies with practical, market-based reforms that aim to provide all Americans with access to high-quality health care at affordable prices.

Community Health Options, a not-for-profit co-op insurance company based in Maine that also sells health plans in New Hampshire, will limit individual enrollments later this month because of “higher-than-expected claims costs.”

It’s an inauspicious sign for the company, which was one of the few successful co-ops created by the Affordable Care Act. Twelve of the ACA’s 23 co-ops have folded or are in the process of closing down, all of which occurred this year.