The final Obamacare open enrollment of President Obama’s presidency starts Tuesday with enrollees facing fewer insurers and higher premiums for health coverage.

However, the impact will largely depend on where the enrollee lives, as some states are faring far worse than others in plan offerings and rates.

The administration wants to get 13.8 million people to sign up between Nov. 1 and Jan. 31, and it hopes about 11 million will pay for coverage throughout 2017. However, some experts doubt whether the administration can reach that goal because of higher plan costs.

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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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Less than half of the approximately 27 million uninsured people in the U.S. are eligible for federal financial assistance, an analysis released Tuesday by the Kaiser Family Foundation shows.

Roughly 11.7 million, or 43 percent of that population, are not taking advantage of some sort of federal assistance to get health insurance that they are eligible for, according to the analysis. That assistant may be in the form of a subsidy to purchase a policy on the Affordable Care Act exchange or a Medicaid plan a consumer is eligible for but not signed up for.

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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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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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A growing number of people in Obamacare are finding out their health insurance plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise.

At least 1.4 million people in 32 states will lose the Obamacare plan they have now, according to state officials contacted by Bloomberg. That’s largely caused by Aetna Inc., UnitedHealth Group Inc. and some state or regional insurers quitting the law’s marketsfor individual coverage.

Sign-ups for Obamacare coverage begin next month. Fallout from the quitting insurers has emerged as the latest threat to the law, which is also a major focal point in the U.S. presidential election.

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Obamacare will likely see a “significant slowdown” in enrollment next year, a Thursday analysis from S&P Global Ratings projects.

The report suggests effectuated marketplace enrollment will range between 10.2 million and 11.6 million in 2017. The analysts say their forecast “is clearly a bump in the road, but doesn’t signal ‘game over’ for the marketplace.”

“The marketplace would benefit from growth in enrollment, especially if it helps improve the morbidity of the risk pool. But 2017 will likely not be the year the marketplace sees significant expansion,” the report says.

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The Obama administration is worried that insurers bailing out of the health law’s markets may prompt their customers to drop out, too. So it plans to match affected consumers with remaining insurance companies.

The hope is to keep people covered, but there’s concern that the government’s match-making will create confusion and even some disappointed customers.

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South Carolina became the fifth state to have only one company offering health insurance through its Affordable Care Act exchange.

The South Carolina Department of Insurance announced on Tuesday that Blue Cross Blue Shield of South Carolina will be the sole provider for South Carolinians looking to get covered through the ACA, better known as Obamacare, according to The Post and Courier.

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The Obama administration will use targeted, digital messages and online networks such as Twitter in a sweeping campaign to get young adults to sign up for health insurance during the Affordable Care Act’s fall open enrollment, appealing to a group seen as critical to the law’s success.

The administration, which announced the new push on Tuesday, is betting the aggressive campaign will resonate with uninsured consumers age 35 and under. But some Republicans are already opposing some of the outreach efforts and health analysts warn lackluster sign-ups would drive more insurers to abandon the exchanges.

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