Can Clinton save health overhaul from its mounting problems?

UnitedHealth, Aetna, and Humana have all left the Obamacare exchange, and additionally many smaller insurance companies have left. The real choice in the future is either a hugely expensive for-profit oligopoly with the market power to charge high prices even to healthy people and to stop insuring sick people, or else a government-run single payer system – such as is in place in nearly every other advanced economy – dedicated to lower premiums and better care for everyone. “If the program gets over this set of troubles, it could do well”.

Alexander – who noted that Republicans warned President Obama six years ago that the Patient Protection and Affordable Care Act would result in higher insurance premiums for millions of Americans – called on Congress to “take a good, hard look at Obamacare, which is bearing down on American families in a way that can not be allowed to continue”.

There are problems in the ACA, but correctable ones. Democrat Hillary Clinton wants to expand the ACA and find new ways to lower costs. That picture will be the same for many Americans across the country’. That’s why the out-of-pocket cost for premiums is projected to remain roughly the same, even if the actual rates were to rise 50 percent instead of 25 percent. Importantly, they are just as satisfied with their coverage as people with employer plans. In general, the ACA has attracted more sick people seeking more costly care than expected. Americans who are not in either of those categories are choosing to go uninsured and pay a penalty rather pay thousands a year for coverage. They saved an average of $33 per month. That leaves 9,700 people in Pinal County, Arizona, with no Obamacare plan options in 2017.

That trend is obviously worsening, dramatically so in some places, such as Tennessee.

In a January 7 memo requesting an explanation from TDCI for the steep premium increases approved in 2015, Senator Green noted constituent complaints from within his district and recorded in press accounts from across the state due to premium increases “as great as 56 percent”.

Not all state markets are in trouble. Some analysts feel she’s overstating the case, pointing out that Tennessee had unusually low premiums at the outset of Obamacare, and is now catching up.

Last week in the approval hearing for rate increases in Tennessee for 2017, “Commissioner McPeak declared that Tennessee’s Obamacare Exchanges are “very near collapse” but still approved unbearable rate hikes to prop up a failed federal program”, Senator Green noted.

The failure of young people to sign up in expected numbers is connected to the weakness of the Obamacare mandate. But some insurers have been granted much steeper, double-digit hikes for the policies.

If insurers had no idea who’d be sick and who’d be healthy when they sign up for insurance (and keep them insured at the same price even after they become sick), this wouldn’t be a problem.

However, the CBO figures do not reflect how many people need to enroll to be successful, Cox said.

At this stage, Obamacare is clearly not at all what the insurance companies signed on for.

Insurance giant Aetna disclosed in mid-August that in 2017 it will pull out of the federal online exchange – HealthCare.gov – in most of the states where the exchange operates and will sell policies only in Virginia, Delaware, Iowa and Nebraska. Trump and other ACA critics have ample ammunition.