A majority of physicians look negatively at their profession and are increasingly burdened by new reimbursement models, according to a new survey.

The Physicians Foundation, a not-for-profit organization that supports research on the impact of the Affordable Care Act on physician groups, surveyed 17,236 physicians across the U.S. (PDF) on a variety of issues related to their field.

The report highlighted low morale among a majority of physicians. Fifty-four percent of physicians rated their morale as somewhat negative or very negative and only 37% were positive about the future of their profession. This is a decrease, however, from 2012 when 68% of physicians described low morale when surveyed by the organization.

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Failing insurers. Rising premiums. Financial losses. The deteriorating Obamacare market that the health insurance industry feared is here.

As concerns about the survival of the Affordable Care Act’s markets intensify, the role of nonprofit “co-op” health insurers — meant to broaden choices under the law — has gained prominence. Most of the original 23 co-ops have failed, dumping more than 800,000 members back onto the ACA markets over the last two years.

Many of those thousands of people were sicker and more expensive than the remaining insurers expected — and they’re hurting results.

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President Obama has an opportunity to win a positive legacy in health care. Although his attempt at payment reform, Obamacare, has failed in public opinion, he is also encouraging important initiatives in medical innovation. The Cancer Moonshot and Precision Medicine Initiative represent investments in innovation that can bring big payoffs. However, they will not succeed fully unless the Food and Drug Administration allows patients access to new therapies. Legislation modernizing the FDA, the 21st Century Cures Act, is being fumbled inches away from the Congressional end zone. Presidential leadership is needed.

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Congressional Republicans are warning the Obama administration not to settle with insurers that have sued the government over an Affordable Care Act program to compensate them for losses under the law, saying such a move would bypass spending limits set by Congress.

Forty-six House Republicans signed a letter sent Thursday to Health and Human Services Secretary Sylvia Mathews Burwell saying they oppose any settlements and could sue the administration to block them.

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With major insurers retreating from the federal health law’s marketplaces, California’s insurance commissioner said he supports a public option at the state level that could bolster competition and potentially serve as a test for the controversial idea nationwide.

“I think we should strongly consider a public option in California,” Insurance Commissioner Dave Jones said in a recent interview with California Healthline. “It will require a lot of careful thought and work, but I think it’s something that ought to be on the table because we continue to see this consolidation in an already consolidated health insurance market.”

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Hillary Clinton surely is hoping health reform remains a side issue the presidential campaign as bleak news of its failures have propelled Obamacare back into the spotlight.  Clinton owns Obamacare after telling Iowa voters: “I will defend the Affordable Care Act, but as president I want to go further.”  She actually wants to double down, even after seeing public support for the health law tumble. She wants to create another big government “public option” that would have unlimited calls on taxpayer dollars and government force and would quickly drive remaining private insurers out of the market, leaving people with only the “choice” of a government-run health plan.  We can and must do better than Obamacare, and the voters know it.

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