Progressive senators and activists are launching a campaign Thursday calling for every American to have the choice of a public health insurance option.

They aim to build on Democratic presidential candidate Hillary Clinton’s support for a public option with what they hope will be the biggest health care push by Democrats since the passage of the Affordable Care Act in 2010.

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A grace period in President Barack Obama’s health care law is allowing exchange customers to dodge the penalty while also helping them get more out of their medical coverage.

Insurers told the administration Monday in an annual meeting that making changes to the grace period is one way to make it easier for them to continue to participate in Obamacare’s exchanges. As is, the grace period leads to higher costs for health insurance policies, forcing some insurers to leave the exchanges due to massive financial losses.

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A top Obama administration health official indicated Wednesday that there are discussions underway about a settlement with insurance companies over Obamacare payments. This possibility has drawn alarm from Republican lawmakers, who warn that the administration is seeking to get around limitations set by Congress. Several insurers have sued the administration for funds they are owed under an Obamacare program called risk corridors, which is meant to protect insurers from heavy losses in the early years of the health law. A shortfall in funds has limited payouts. Congress enacted a provision preventing the administration from shifting funds into the program in 2014 but warn that judicial settlements now could be a way around that prohibition, for what they term to be a “bailout” of insurers.

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Sen. Lamar Alexander is introducing a bill Wednesday that would extend Affordable Care Act subsidies to plans off of the exchanges for some eligible consumers.

The Tennessee Republican is proposing that states could opt to expand the Obamacare subsidies to plans sold off of the exchanges.

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The state-run insurance marketplaces created under the Affordable Care Act may not be sustainable, a GOP report released Tuesday by a House committee concludes.

The Energy and Commerce Committee report concludes that the $5 billion the federal government committed to building state-based exchanges has resulted in a failed experiment, and says that none of the exchanges are currently financially self-sustaining. The report comes ahead of a hearing Wednesday on the Affordable Care Act called by the committee’s health and oversight subcommittees.

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The House Ways and Means Committee on Thursday approved a GOP bill that responds to the failure of about two-thirds of the co-op insurers created under the Affordable Care Act.

The bill, which passed by a voice vote, would exempt people who lost insurance because the co-op through which they bought coverage folded mid-year from the Affordable Care Act’s individual mandate.

Roughly 750,000 families have had their coverage disrupted by the closure of 16 of the 23 co-ops created under the 2010 health care law, all citing financial problems, Committee Chairman Kevin Brady (R-Texas) said during the hearing. The bill would exempt consumers from the individual mandate for the remainder of that year, and they would be required to sign up for coverage during the next enrollment period.

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The Health Republican Insurance of New Jersey announced Monday plans to shut down, hours after Sen. Ben Sasse introduced the CO-OP Consumer Protection Act.

The Garden State’s Obamacare co-op plans to close at the end of the year, making it the 17th of 23 to fail and cost Americans their health plans.

“Families in New Jersey have just been gut-punched and the last thing that Washington should do is force these CO-OP victims to pay Obamacare’s individual mandate. This started in Nebraska and Iowa and has been a catastrophe for countless Americans,” Sasse said in a press release.

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According to a recently-updated analysis conducted by the Kaiser Family Foundation of 14 major cities, the lowest-cost and second-lowest cost silver plans are expected to rise by a weighted average of 9% in 2017. But residents in some states are going to have it far worse. Through last weekend, insurers in a dozen states had their rate requests for 2017 finalized. Residents in the vast majority of the approved states are looking at double-digit percentage increases. As aggregated by ACASignUps.net, four of the first 12 states to finalize their rate requests for 2017 are looking at weighted increases of at least 30%.

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The Obama administration has repeatedly inferred that most people are fully subsidized under Obamacareand the big 2017 rate increases therefore don’t matter:

“Headline rate increases do not reflect what consumers actually pay,” Kathryn Martin, HHS’s acting assistant secretary for planning and evaluation, said in a statement. “Even in a scenario where all plans saw double-digit rate increases, the vast majority of consumers would continue to have affordable options.”

To be as precise as they are careful to be, they correctly claim that 85% of those buying on the exchanges are subsidized. But they also never mention that half the people who buy Obamcare individual health insurance–on and off the exchanges–don’t get a subsidy and take the full whack from all of the big rate increases and even higher deductibles. The middle class seems to be invisible to them.

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As the election enters the final two months, reporters have been speculating on an “October Surprise,” or perhaps a September one.

There are plenty of candidates, beginning with more Wikileaks about Hillary Clinton’s emails as Secretary of State. There is speculation about pay-to-play at the Clinton Foundation and what’s hiding in Donald Trump’s taxes.

What has received too little attention is the steady collapse of Obamacare and the impact that will have on insurance premiums, which will arrive just before Election Day. The Chicago Tribune called them “cardiac-arrest-inducing premium increases.”

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