This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers’ risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the costs and complexity of administration. These effects warrant careful consideration by policymakers as they consider measures to achieve stability in the individual market in the long term.

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Navigator groups that help educate and enroll consumers in the Affordable Care Act insurance exchanges are shutting down because the federal government isn’t paying them.

Several navigator organizations, including the University of South Florida, which received the country’s largest federal grant for navigation services in 2016, are suspending education and outreach activities ahead of the 2018 open enrollment period that is slated to begin Nov. 1.

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How do you define “single payer”? A common theme is to give government a dominant role in the pricing and possibly delivery of services—supporters often assert that some measure of cost would be reduced. The Urban Institute’s Health Policy Center says that Bernie Sanders’ previous proposal in 2016 would have increased federal costs by $32 trillion over the next decade. Even Democrats would have a hard time getting support for this unprecedented expansion of federal spending. In spite of the superficial allure of Medicare for all, Democrats are not eager to upend the health system that President Obama created.

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Two Republican senators are launching yet another attempt at repealing Obamacare, preparing to offer legislation that would try to bridge one of the key dividing elements of an effort that has twice failed to pass the senate, according to a section-by-section analysis obtained by NBC News.

It’s too early to gauge whether or not the approach could muster enough support to pass either the Senate or the House, or even if GOP leadership would take it up, but it’s a last-ditch effort by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., to repeal the Affordable Care Act.

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Half of Virginia’s counties now are on track to have no health insurers offering Obamacare plans in 2018 after an insurer reversed a decision to sell individual health coverage in much of the state.

The pullback by Optima Health in Virginia ends a brief, two-week period in which every county in the United States was projected to have at least one Obamacare insurer next year.

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Ohio Gov. John Kasich on Friday said that some of the essential health benefits that had been set up under Obamacare were too limiting to customers, proposing that someone have the option to buy a plan that excludes maternity coverage while explaining his decision to mandate autism coverage in his state.

Kasich, a Republican, was appearing in a panel in Washington alongside Colorado Gov. John Hickenlooper, a Democrat with whom he has been working on an Obamacare stabilization plan to lower the costs of premiums and give customers more choices for health insurance plans.

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“While most reasonable people would welcome a bipartisan outcome to the Obamacare mess, the solutions proffered thus far would do little more than shore up the bad policies already in place with another slate of bad policies. We need legitimate, long-term reforms,” argues Sen. Hatch. “Case in point: Some are working on an approach that amounts to little more than a congressional bailout of Obamacare, including pumping tens of billions of dollars into the already failing system in the form of cost-sharing reduction payments and reenacting a temporary reinsurance program included in Obamacare that has expired.”

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The Kaiser Family Foundation’s Larry Levitt says, “States actually have a lot flexibility in theory under current waivers, but the guardrails are very hard to meet, which limits the amount of flexibility in practice.” During the repeal-and-replace effort, Republicans wanted to remove some of those “guardrails”—allowing states to chip away more substantively at some of the law’s benefit mandates and coverage guarantees. Sen. Lamar Alexander, though, is trying to keep his proposal more tailored. He’s focusing more on changes to the process of seeking a waiver than on the substance of what can be waived.

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Single-payer is back on the docket in California. Late last month, Assembly Speaker Anthony Rendon announcedthat he’d formed a special committee “to develop plans for achieving universal health care in California.”

Rendon has been under pressure from progressive activists all summer, ever since he shelved SB 562, a bill passed by the state Senate on June 1 that would put all the state’s residents into a new, state-run single-payer healthcare system. At the time, he deemed it “woefully incomplete.” SB 562 did not specify how, exactly, the state would pay for single-payer.

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Donald Trump’s gleeful deal with the Democrats—ratcheting up the debt ceiling, as well as the ire of the Republican establishment—puts John Cogan’s mind on 1972. Starting in February of that year, the Democratic presidential candidates engaged in a bidding war over Social Security to gain their party’s nomination. Sen. George McGovern kicked off the political auction with a call for a 20% increase in monthly payments. Sen. Edmund Muskie followed suit, as did Rep. Wilbur Mills, chairman of the Ways and Means Committee. Former Vice President Hubert Humphrey, never one to be outdone, offered a succulent 25%.

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