No wonder Politifact awarded President Barack Obama its 2013 “Lie of the Year” award for his Obamacare promise, “If you like your health plan, you can keep it.” My wife has been trying to do exactly that for three years, and has failed every time. But at least she was able to keep her doctor—until now.

I have previously discussed my wife’s struggles to find and keep coverage in the age of Obamacare. It was never a problem before Obama and Democrats decided the government needed to improve access to coverage.

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Along with “stakeholders” (campaign donors), “investments” (government spending) and “obstruction” (Congress), one of our favorite political euphemisms is “improper payments.” That’s how Washington airbrushes away the taxpayer money that flows each year to someone who is not eligible, or to the right beneficiary in the wrong amount, or that disappears to fraud or federal accounting ineptitude. Now thanks to ObamaCare, improper payments are soaring.

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“You bet I voted for that bill. I’m proud I did it!” yelled Russ Feingold at a Wisconsin campaign stop in 2010. That pride—in ObamaCare—lost the three-term Democratic senator his job. Now his party’s ownership of the health-care law may once again decide the Senate.

ObamaCare is roaring back as a political liability to Democrats in a way not seen since that 2010 wave election. Right in time for this fall’s presidential contest, insurers are bailing out of the government system, leaving millions of voters with dwindling options and skyrocketing premiums. ObamaCare was always destined to crack up, but there is something notable that it comes precisely as so much control of Washington is up for grabs.

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Progress in reducing the number of people without health insurance in the U.S. appears to be losing momentum this year even as rising premiums and dwindling choice are reviving the political blame game over President Barack Obama’s health care law.

The future of the Affordable Care Act hinges on the outcome of the presidential election, and it’s shaping up as a moment of truth for Republicans.

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Floridians who buy their own health insurance in 2017 are likely to see their premiums rise by an average of 19 percent over the current year, according to an analysis released Friday by the state’s Office of Insurance Regulation.

The average increase calculated by the state applies to all health insurance plans sold in Florida next year that comply with the Affordable Care Act’s minimum coverage requirements, whether those plans are sold on the ACA exchange at HealthCare.gov or off of it.

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Under the ACA, health insurance marketplaces, also called health exchanges, were set up to facilitate the purchase of health insurance in each state. Customers are free to choose from a set of standardized healthcare plans from participating insurers, and those policies are eligible for federal subsidies.

But insurers have been fleeing the exchanges, arguing that they are loss makers and the types of people attracted to them make the risks too great for the insurers to provide affordable (and profitable) policies.

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Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals.

A new McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that 75% of the offerings on their exchanges in 2017 will likely be health-maintenance organizations or a similar plan design known as an exclusive provider organization, or EPO. Both typically require consumers to use an often-narrow network of health-care providers—in some cases, just one large hospital system and its affiliated facilities and doctors.

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Massachusetts will be responsible for at least $162 million in new costs over the next decade to fund the federal expansion of health insurance coverage, according to a new report.

The paper from the Pioneer Institute, a free-market-oriented Boston think tank, said that additional spending will squeeze the state budget and divert money from other priorities such as education and transportation.

The costs come in the form of a fee that is part of the Affordable Care Act, which extended insurance coverage to millions of people. The law makes more Americans eligible for Medicaid and provides subsidies to many people on private insurance plans, depending on their level of income. Pioneer said it is the first organization to calculate the long-term costs of the fee.

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In the last few years, even though premiums in the Affordable Care Act’s health insurance marketplaces were rising, most customers could avoid a big price rise by shopping for a cheaper plan.

Next year, according to a preliminary analysis, that is going to be a lot harder.

Even someone who shopped wisely this year and is willing to switch plans to get the best deal next year is looking at an average premium increase of 11 percent, according to an analysis of rate filings in 18 states and the District of Columbia provided by the McKinsey Center for U.S. Health System Reform.

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Senate Majority Leader Mitch McConnell (R-Ky.) says major changes are coming for ObamaCare next year, no matter who wins the White House.

Pointing to rising costs and shaky insurance markets, McConnell said the next president will have to work with Congress to keep the situation from worsening, though he did not specifically say the healthcare law would be repealed.

“It will be revisited by the next president, whoever that is,” McConnell said at an event Monday with the Kentucky Chamber of Commerce. “No matter who wins the election, no matter who’s in control of Congress.”

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