ObamaCare’s impact on health costs.

While the Affordable Care Act has achieved a second victory before the Supreme Court and produced significant coverage gains, it might also have produced a less positive outcome: in an NBER working paper, Penn LDI colleagues Mark Pauly, Adam Leive and Scott Harrington found that a large portion of non-poor (measured by income above 138% of the poverty level) who gained coverage now have a higher financial burden and lower welfare (well-being) than when they were uninsured. The authors call this extra burden a “price of responsibility” for complying with the individual mandate to purchase coverage.

With the health insurance markets open for next year’s enrollment, Eve Campeau says she’s planning to look carefully at the fine print. Last time she shopped, she switched to a plan with a lower monthly premium, but found herself paying far more out-of-pocket for medications and doctor visits. While she might be saving money on the premium, she is reluctant to go to seek medical care because of the up-front cost.

A total of $1.23 billion in federal taxpayer dollars has now been sunk in 12 of 23 co-ops created under Obamacare that have gone out of business, representing another Obamacare failure, lawmakers say. Co-ops in Arizona and Michigan went out of business last week, adding themselves to the 10 that have already failed in Utah, Kentucky, New York, Nevada, Louisiana, Oregon, Colorado, Tennessee, South Carolina, and a co-op that served both Iowa and Nebraska.

Last week, the Centers for Medicare and Medicaid Services released the 2016 premium data for the “benchmark” plans in the states using federal exchanges. … This data, which showed premiums rising an average of 7.5 percent, is useful. But it is limited. We’d like to think that this tells us “how much premiums went up,” but it’s not that simple.

Higher deductibles are prompting some consumers to skip or postpone doctor visits because they are unable to afford the additional out-of-pocket costs. Too many consumers only factor in the amount of the monthly premium and discount the importance of other criteria such as the cost of the copayments, prescription drugs and deductible. As more companies are increasingly shifting a larger percentage of health insurance costs to their workers, consumers need to examine all options.

“Cheap” could cost you more for Obamacare next year. People who buy the cheapest health plans on the biggest Obamacare exchange without getting financial assistance are facing the largest increases for premiums and out-of-pocket costs in 2016, new analyses show.

In Tennessee, the state insurance commissioner approved a 36 percent rate increase for the largest health insurer in the state’s individual marketplace. In Iowa, the commissioner approved rate increases averaging 29 percent for the state’s dominant insurer. Health insurance consumers logging into HealthCare.gov on Sunday for the first day of the Affordable Care Act’s third open enrollment season may be in for sticker shock, unless they are willing to shop around. Federal officials acknowledged on Friday that many people would need to pick new plans to avoid substantial increases in premiums.

For the press, the debate over ObamaCare is over. There may be a few proverbial Japanese soldiers wandering on isolated islands yammering on about the failure of ObamaCare, but word will eventually filter down to them, too. This assumption is so deeply embedded that it is impervious to new evidence that ObamaCare is an unwieldy contraption that is sputtering badly. Yes, ObamaCare has covered more people and has especially benefited those with pre-existing conditions (to be credible, Republican replacement plans have to do these things, as well), but the program is so poorly designed that, surely, even a new Democratic president will want to revisit it to try to make it more workable.

Texas — In rural Borden County, 12 people signed up for Obamacare this year. Livid over the government telling them they must buy something and loath to take anything that looks like a “handout,” the uninsured here are likely to stay that way. As Obamacare’s third open enrollment season began Sunday, this rock-solid conservative community of about 650 people offers a window into the challenges health law advocates face to expand coverage around the country.

Obamacare’s third open enrollment season kicked off yesterday, beginning the next chapter in its turbulent history. Today’s post discusses what we know about Obamacare. Tomorrow’s will discuss what we don’t yet know.