About 4,500 Medical University of South Carolina patients currently covered by Consumers’ Choice Health Plan need to pick a new policy by Tuesday to remain insured on Jan. 1. Medical University Hospital CEO Pat Cawley told the MUSC Board of Trustees on Thursday that the announcement created “an administrative nightmare.”

Only 35% of 67,000 Consumers’ Choice customers across the state have selected a new plan so far.

The two-year “Cadillac tax” delay under consideration by Congress is the worst kind of special-interest legislation. It will enrich labor unions and big business at the expense of taxpayers. ObamaCare’s Cadillac tax is a clunky but constructive first step in reforming the employer tax exclusion. It has problems—its structure as an excise tax is punitive, and it contains carveouts for favored Democratic constituencies—but the basic idea of equalizing the tax treatment of employer- and individually-purchased health insurance is a good one.

The lone health insurance cooperative to make money last year on the ObamaCare insurance exchanges is now losing millions and suspending individual enrollment for 2016. Maine’s Community Health Options lost more than $17 million in the first nine months of this year, after making $10.9 million in the same period last year. A spokesman said higher-than-expected medical costs have hurt the co-op. An Associated Press review of financial statements from 10 of the 11 surviving co-ops shows that they lost, on average, more than $21 million in the first nine months of this year.

Under ObamaCare, most health insurance plans must cover a set of preventive services without any cost to patients. Patients are soon discovering, however, that anything else discussed during a visit with their health care providers could cost them. “There are times when a person might be charged cost-sharing for a service that is unrelated to the screening or preventive service, while they are not charged cost-sharing for the screening or preventive service itself,” says Jesse Bushman, director of advocacy and government affairs at the American College of Nurse-Midwives. But doctors don’t always tell patients about the possibility of fees up front.