President Obama says his signature domestic policy, the Affordable Care Act, needs some fixes.

“In my mind the [Affordable Care Act] has been a huge success, but it’s got real problems,” Obama said in an interview with New York Magazine published Sunday.

The Affordable Care Act, or Obamacare, created a new marketplace, known as the exchanges, which many insurers have struggled to adapt to. Several insurers have said they won’t offer marketplace plans next year, and the retreat of major insurers including UnitedHealth, Aetna and Humana in recent months have highlighted some of the shortfalls of the law.

. . .

When open enrollment in Obamacare starts next month, enrollees in four states will be able to choose plans from only one insurer.

Alaska, Alabama, Wyoming and Oklahoma have confirmed to the Washington Examiner that they will have only one insurer offering Obamacare plans for 2017. The revelation comes in the wake of defections from some major insurers that have left Obamacare exchanges due to financial losses.

. . .

Vermont has received tentative approval from the Obama administration to establish an all-payer reimbursement system for healthcare providers in the state starting in January.

Maryland long has had an all-payer system, but it covers only hospitals. Vermont plans to use an accountable care organization-type structure that would cover all providers. All-payer systems require all insurers, whether private, Medicare or Medicaid, to pay similar rates for services.

. . .

Minnesota’s commerce commissioner called for reforms to strengthen the federal marketplace Friday after announcing monthly premium increases of at least 50 percent for 2017.

“While federal tax credits will help make monthly premiums more affordable for many Minnesotans, these rising insurance rates are both unsustainable and unfair,” Minnesota Commerce Commissioner Mike Rothman said in a statement. “Middle-class Minnesotans in particular are being crushed by the heavy burden of these costs. There is a clear and urgent need for reform to protect Minnesota consumers who purchase their own health insurance.”

. . .

Democratic presidential nominee Hillary Clinton took a shot at President Obama’s landmark health care program in private remarks to donors even as she pledged to defend the law, according to audio of her remarks obtained by the Washington Free Beacon.

Parts of the Affordable Care Act, better known as Obamacare, “need fixing,” Clinton told donors during a September 2015 fundraiser at the Marriott Marquis hotel in Washington, D.C.

. . .

Proposals to make changes to the Affordable Care Act from both sides of the political aisle show that President Obama’s health care law will almost certainly needs changes to survive.

The president, Hillary Clinton, and nearly one-third of the Senate have endorsed a new government-sponsored health plan, the so-called public option, to give consumers on Obamacare exchanges an additional choice. A significant number of Democrats, for whom Senator Bernie Sanders spoke in the primaries, favor a single-payer arrangement.

Donald Trump and Republicans in Congress, on the other hand, would go in the direction of less government, reducing federal regulation and requirements so insurance would cost less and no-frills options could proliferate. Mr. Trump would, for example, encourage greater use of health savings accounts, allow insurance policies to be purchased across state lines and let people take tax deductions for insurance premium payments.

. . .

The Affordable Care Act’s defenders have spent the past six years dismissing the law’s critics for predicting that it would enter a “death spiral.” But it turns out we were prophets – just look at what’s happening all across Arizona.

The past couple of months have seen the Affordable Care Act’s – Obamacare’s – online exchanges crumble in our state. Three years in, health-insurance companies have discovered that the law’s top-down, one-size-fits-all approach is a bureaucratic and financial disaster. So naturally, they’re abandoning the law in droves.

. . .

We keep reading that Donald Trump poses a unique threat to constitutional norms if he’s elected. His liberal critics would have more credibility if they called out the ObamaAdministration for its current (not potential) abuses of power, and here’s an opportunity: The Administration is crafting an illegal bailout to prop up the President’s health-care law.

News leaked this week that the Obama Administration is moving to pay health insurers billions of dollars through an obscure Treasury Department account known as the Judgment Fund.

. . .

It never rains that it doesn’t pour. Even as nonpartisan experts at the Government Accountability Office concluded that the Obama administration broke the law with Obamacare’s reinsurance program, the Washington Post reported the administration could within weeks pay out a massive settlement to insurers through another Obamacare slush fund—this one, risk corridors.

The Post article quoted Republicans criticizing risk corridor “bailouts.” But in reality, the Obama administration itself has admitted using risk corridors as a bailout mechanism—trying to pay insurers to offset the costs of unilateral policy changes made to get President Obama out of a political jam.

. . .

A look at transcripts of Clinton stump speeches since she kicked off the general election campaign on Labor Day finds the Democratic candidate almost never talks about Obamacare. She doesn’t promise to expand it. She doesn’t promise to protect it. She doesn’t extol its benefits. She just doesn’t mention it.

There’s no doubt Obamacare is in trouble. Enrollment in the exchanges has fallen far short of projections. The purchasers of policies have turned out to be older, and in need of more care, than expected. Major insurers are pulling out of the exchanges altogether. Premiums are going up. Deductibles are skyrocketing, meaning many are left to pay most of their healthcare costs themselves.