Articles on the implementation of ObamaCare.

The end of Barack Obama’s presidency is near, and his most important domestic policy accomplishment is teetering and threatening to fall and smash to pieces.

Obamacare, or at least the most-touted part of it, is failing, and for not for mere technical reasons.

By expanding Medicaid, it got more people insured. But the president’s experiment manipulating private insurance markets has created no net benefit and is headed for disaster unless enrollment miraculously skyrockets.

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Under pressure to stabilize wobbly insurance markets nationwide, the Obama administration is making a new push to sign up Americans for health coverage through the Affordable Care Act, aiming to increase enrollment by about 1 million in 2017. With insurers canceling health plans or raising premiums by double digits in many parts of the country, that represents only modest enrollment growth over 2016.

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The 40% “Cadillac” Tax on expensive employer-sponsored health insurance is on a deathwatch because both parties in Congress dislike it. It would be best if Congress were to replace the Cadillac Tax with a simple and clear limitation on the tax preference for employer-paid premiums, as is called for the House GOP’s “Better Way” health plan. For decades, economists have complained that the open-ended tax break for employer-paid health insurance premiums is a major distortion in the marketplace. This approach is fair and promotes more transparency in the health care marketplace.

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The forecast illustrates the administration’s confidence in enrolling more people and keeping those who are covered from dropping out in a challenging year. But the Obamacare exchanges are still not attracting enough young, healthy and higher-income individuals who could help spread the health-care costs of the sickest over a bigger group.

“What we are still missing is the young and invincible,” said Deep Banerjee, an analyst at S&P Global Ratings. “The exchange market has to grow a lot more to become stable.”

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When the Affordable Care Act was signed into law in 2010, it promised to extend health insurance to tens of millions of people. And although the law has helped push the U.S. uninsured rate down to a record low, the ACA’s new insurance markets are proving to be volatile, with insurers recording big losses and pulling out. Meanwhile, there are still millions of people without health insurance.

One key to stabilizing the law is drawing in more of those who are uninsured, particularly the younger, healthier ones. In fact, young people are the most likely to go uninsured, according to a detailed analysis by the Kaiser Family Foundation. The analysis shows that those who lack insurance cut across age and income and vary from state to state. Taking a look at who these people are can give clues to how the health law is falling short, and what can be done to fix it.

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Longtime ObamaCare lobbyists are soundly rejecting one of Hillary Clinton’s most prominent healthcare pitches: the public option.

Leaders of the nation’s largest hospital, pharmaceutical and insurer trade groups said on Tuesday they wouldn’t support a Clinton administration’s push for a public option without first ensuring the Obamacare marketplaces work.

“We think we need to make these [marketplaces] viable before we give any consideration of going to a public option,” Rick Pollack, president of the American Hospital Association, told a crowd at the U.S. Chamber of Commerce.

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The Affordable Care Act (ACA) extends health insurance coverage to people who lack access to an affordable coverage option. Under the ACA, as of 2014, Medicaid coverage is extended to poor and near poor adults in states that have opted to expand eligibility, and tax credits are available for low and middle-income people who purchase coverage through a health insurance Marketplace. Millions of people have enrolled in these new coverage options, and the uninsured rate has dropped to the lowest level ever recorded. However, millions of others are still uninsured. Some remain ineligible for coverage, and others may be unaware of the availability of new coverage options or still find coverage unaffordable even with financial assistance.

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When the Affordable Care Act’s health insurance marketplace opens in two weeks, many consumers will have a new option for the law’s fourth open-enrollment period: standardized health plans that cover basic services without a deductible.

With many health plans on the marketplace coming with deductibles in the thousands of dollars, consumers have complained that they were getting little benefit beyond coverage for catastrophic problems. The new standardized options are meant to address that concern — to ensure that “enrollees receive some upfront value for their premium dollars,” as the Obama administration said.

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Obamacare is collapsing. Its utter failures become more obvious by the day. We all remember the promises of Obamacare, chief among them that the “Affordable Care Act” would lower health care costs. The opposite has occurred. Despite the offer of subsidies through the exchanges, enrollment in Obamacare has been dismal. Younger, healthier individuals have little interest in paying exorbitant premiums for insurance plans that come with $5,000 deductibles. The result has been an unbalanced insurance pool where insurers must charge ever-increasing premiums to continue offering coverage.

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Marilyn Tavenner, the face of private insurers, does not think Affordable Care Act exchanges are about to implode. But she does think Congress will have to make some tough decisions relatively soon about how much to buffer insurers from risk.

“I do not think the exchanges are in a death spiral. I do think they’re unstable, and we have a responsibility to stabilize them,” said Tavenner, president and CEO of America’s Health Insurance Plans, in an interview with Morning Consult. “That’s on all of us.”

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