Insurers on the District of Columbia’s Obamacare insurance exchange want to raise rates by nearly 15 percent in 2019, while Minnesota’s insurers propose to reduce rates by up to about 12 percent.

Insurers in Minnesota can take advantage of a reinsurance program in which the state helps subsidize the biggest insurance claims on Obamacare’s insurance exchanges. Efforts to create a federal reinsurance program ran aground in the Senate because of disagreements over abortion funding.

In Minnesota, all of the state’s five Obamacare insurers are asking for proposed rate reductions of 3 to 12 percent for certain plans. That is a major difference from the final rates for the 2018 coverage year, which ranged from a 16 to 32 percent hike.

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Canada’s single-payer healthcare system forced over 1 million patients to wait for necessary medical treatments last year. That’s an all-time record.

Those long wait times were more than just a nuisance; they cost patients $1.9 billion in lost wages, according to a new report by the Fraser Institute, a Vancouver-based think-tank.

Lengthy treatment delays are the norm in Canada and other single-payer nations, which ration care to keep costs down. Yet more and more Democratic leaders are pushing for a single-payer system — and more and more voters are clamoring for one.

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The Affordable Care Act should be repealed in August and replaced with a new system that lifts national consumer protections and gives control of health care to the states, according to a proposal by a conservative group set to be released Tuesday.

The proposal risks irking centrist Republicans who want to focus on other subjects. Republican leaders have said they have no appetite for another push to repeal the ACA before the November midterm elections unless such a bill clearly has the votes to pass.

Republicans faced a series of obstacles—including internal division and unified Democratic opposition—as their effort to repeal the ACA collapsed last year. There is little evidence those dynamics in Congress have changed.

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Sandy Dowland has been to the emergency room 10 times in the past year and was hospitalized during four of those visits. She has had a toe amputated and suffers from uncontrolled diabetes, high blood pressure, major depression, obesity and back pain.

But her health is not high on the 41-year-old woman’s priority list.

“I have a lot going on,” said the unemployed mother of five who lives in a homeless shelter. She said it’s a struggle just to get herself and children through each day.

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The federal government doesn’t have to pay insurers billions of dollars under an Affordable Care Act program aimed at enticing them into the markets by helping cover their financial risks, a divided federal appeals court ruled Thursday.

In a case brought by Moda Health Plan Inc., the ruling is a blow to insurers hoping to recoup money they say they were owed under the 2010 health law.

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Growth in state spending on the Medicaid program is expected to fall significantly in the short term, according to a new report by state budget officers.

The findings, published Thursday in a report from the National Association of State Budget Officers, or NASBO, show that state Medicaid spending is expected to carry a median growth rate of 4.5 percent in fiscal 2018, and then growth is projected to slow significantly in fiscal 2019, to a median growth rate of 1.5 percent. The organization uses governors’ budgets in making its assessments.

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Democrats are seizing on the Trump administration’s push in court to overturn ObamaCare’s protections for people with pre-existing conditions, hoping to leverage the issue ahead of November’s midterm elections as some Republicans rush to distance themselves from the move.

The Department of Justice’s (DOJ) decision to join a legal battle arguing that one of the most popular parts of ObamaCare should be struck down is being viewed by Democrats as a political gift, with the party apparatus quickly using the issue to attack GOP candidates and rally their base.

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ObamaCare enrollees should brace themselves for another year of double-digit premium hikes.

Average premiums for plans sold through the state and federal insurance exchanges will jump as much as 32% next year, according to a recent report from actuarial firm Milliman. Consumers in some markets could face 80% rate hikes, according to a separate analysis from Blue Cross Blue Shield.

Democrats have pounced on these projections to blame the GOP for “marketplace sabotage.” Senate Minority Leader Chuck Schumer, D-N.Y., remarked that “Republicans and the Trump administration own any and all increases in health care premiums for American consumers.”

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The Affordable Care Act (ACA) established health insurance marketplaces where consumers can buy individual coverage. Leveraging novel credit card and bank account micro-data, we identify new enrollees in the California marketplace and measure their health spending and premium payments. Following enrollment, we observe dramatic spikes in individuals’ health care consumption. We also document widespread attrition, with more than half of all new enrollees dropping coverage before the end of the plan year. Enrollees who drop out re-time health spending to the months of insurance coverage. This drop-out behavior generates a new type of adverse selection: insurers face high costs relative to the premiums collected when they enroll strategic consumers. We show that the pattern of attrition undermines market stability and can drive insurers to exit, even absent differences in enrollees’ underlying health risks. Further, using data on plan price increases, we show that insurers largely shift the costs of attrition to non-drop-out enrollees, whose inertia generates low price sensitivity. Our results suggest that campaigns to improve use of social insurance may be more efficient when they jointly target take-up and attrition.

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Republicans are in a predictable spot as they head to the midterm election: The party failed to repeal ObamaCare, and the press is waving around double-digit premium increases for 2019. Democrats are pinning the blame on Republicans, though the basic problem is still the structure of the Affordable Care Act.

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