ObamaCare’s impact on health costs.

Major insurers participating in Obamacare have won approval for substantial premium hikes next year in a dozen or more states. The increases range as high as 30 percent to 50 percent, according to new data.

Shaken by the decisions of Aetna, UnitedHealthcare, Blue Cross Blue Shield and other giants to pull out of many states after incurring hundreds of millions in losses, state insurance regulators appear more than willing to go along with these rate increases to prop up insurers remaining in the program.

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After months of health insurer exits from the Affordable Care Act marketplace in Arizona, state regulators have approved plans from two companies that will be the only marketplace insurance providers next year.

Blue Cross Blue Shield of Arizona will sell marketplace plans in every county except Maricopa County in 2017. The Phoenix-based insurer’s average rates will increase 51 percent, Arizona Department of Insurance filings show.

Maricopa County residents only option will be Centene Corp., which said it will sell its “Ambetter” plans. State regulators approved a 74.5 percent increase for Centene/Ambetter plans.

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State insurance regulators across the country have approved health care premium increases higher than those requested by insurers, despite a national effort to keep rates for policies sold on Affordable Care Act exchanges from skyrocketing, a USA TODAY analysis shows.

In eight states, regulators approved premiums that were a percentage point or more higher than carriers wanted, said Charles Gaba, a health data expert at ACASignups.net who analyzed the rates for USA TODAY. As of Tuesday, those states are Arizona, Pennsylvania, Colorado, Florida, Georgia, Kansas, Minnesota and Utah.

Pennsylvania regulators approved individual plan rate increases Monday of 33%, which is eight points higher than requested. Two insurers — Keystone Health Plan and Geisinger Quality Option — will also no longer offer plans on the ACA exchange for the state.

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Finalized rates for big health insurance plans around the country show the magnitude of the challenge facing the Obama administration as it seeks to stabilize the insurance market under the Affordable Care Act in its remaining weeks in office.

Market leaders that are continuing to sell coverage through HealthCare.gov or a state equivalent have been granted average premium increases of 30% or more in Alabama, Delaware, Hawaii, Kansas, Mississippi and Texas, according to information published by state regulators and on a federal site designed to highlight rate increases of 10% or more.

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Obamacare was supposed to reduce health expenses for Americans, but that’s not how it’s working out.

Although many have benefited from government subsidies or the ability to buy insurance, health-care costs continue to rise and eat up a bigger percentage of household budgets.

In a recent though little-noticed study, economist Ann C. Foster at the Bureau of Labor Statistics found that health costs made up a record 8% of an average household’s budget in 2014, the last year for which data is available.

That’s a 40% jump compared to 10 years ago, and a 21% increase since 2010, the year the Patient Protection and Affordable Care Act was passed. Parts of the law were implemented shortly afterward but it wasn’t until 2014 that most of it took effect.

Health and Human Services Secretary Sylvia Mathews Burwell recently told reporters that in the marketplace, “85 percent of folks receive subsidies.”

This leaves out something important: that there are millions of people buying their own coverage outside of the marketplace. And none of them receive subsidies. So they don’t have any financial cushion to protect against the larger premium increases most observers expect to see in 2017.

“They are the red-haired stepchildren of American health reform,” says Kevin Coleman, head of research and data at HealthPocket. “They don’t have strong sympathy within the government and have typically been ignored.”

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It keeps getting harder to sell Affordable Care Act policies, says Steven Mendelsohn, a Montgomery County licensed insurance salesman.

It’s bad enough that United Healthcare pulled out of the Pennsylvania exchange that sells the subsidized health insurance parties last year, when rates went up 10%. Or that Aetna — which less than 10 years ago dominated the local market for individual policies — stopped writing the policies here earlier this year, when rates went up another 10%.

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Delawareans are again facing steep price increases for health insurance next year under the Affordable Care Act.

Insurance Commissioner Karen Weldin Stewart has approved an average rate increase of 32.5 percent in the individual market for Highmark Blue Cross Blue Shield of Delaware, which has the vast majority of the individual market share in Delaware. That follows an average premium increase of 22.4 percent for individual Highmark plans this year.

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States with some of the worst Obamacare news this year also have the biggest need for people to sign up, presenting a major challenge to advocates for the healthcare law.

Of the six states where insurers have proposed the steepest price increases affecting the most people, five have among the highest uninsured rates in the country, according to data compiled by independent analyst Charles Gaba.

In Tennessee, where 11 percent of residents remain uninsured, average monthly premiums could rise by 56 percent next year if insurers follow through with the prices they have proposed.

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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.”

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