People with ACA plans drop their plans at a much higher rate than in the pre-Obamacare era.  The average monthly attrition rate under Obamacare in 2015 (3.6%) was nearly two-thirds higher than the average monthly attrition rate in the non-group market in 2006 (2.2%). This occurred even though 86% of Obamacare enrollees were receiving subsidized coverage. We can only imagine what would have happened had enrollees borne the full cost of their premiums (as was the case in 2006).  The reality is that while the non-group market was never perfect, it performed much more smoothly before the ACA than most critics ever gave it credit.

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Alex Azar will soon make his most consequential decision as health and human services secretary. President Trump has asked HHS to expand health-insurance protections in a way that could make coverage more affordable and improve the outlook for Obama Care’s risk pools. Whether Mr. Azar will oblige is uncertain. Some officials don’t understand that Mr. Trump’s request would expand consumer protections, or mistakenly believe HHS lacks the authority to grant it.

The need for action is clear, as ObamaCare premiums keep skyrocketing. Rate hikes as high as 91% will hit many consumers just before Election Day. Maryland insurance commissioner Al Redmer warns ObamaCare is in “a death spiral.”

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The latest plan is being forged by leaders at the conservative think tanks Heritage Foundation and the Galen Institute, along with former senator Rick Santorum and Yuval Levin of the Ethics and Public Policy Center. They’ve been meeting regularly over the past eight months to craft a recommendation for Congress to repeal much of the ACA’s coverage requirements and taxes, turn over some of its spending to states through block grants and expand the use of tax-free health savings accounts.

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