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2016 Outlook: No Individual PPO’s Available to Health Insurance Consumers in Houston

Posted by Kemberlee Kaye October 28, 2015 at 1:30pm

 

But you can have an HMO

 

Consumers living in the country’s fourth largest city will no longer be able to purchase an individual PPO.

 

Market changes sparked by implantation of Obamacare are putting the squeeze on the self-employed and those who purchase health insurance outside of a large employer sponsored PPO.

 

The Lone Star State’s largest PPO provider, Blue Cross Blue Shield of Texas announced earlier this month that beginning in 2016, the would no longer offer individual PPO plans, though some enrolled in certain plans in 2010 might be grandfathered in.

 

Just yesterday, I received a notification from my health insurance provider that my plan, an HMO, would be cancelled.

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http://legalinsurrection.com/2015/10/2016-outlook-no-individual-ppos-available-to-health-insurance-consumers-in-houston/

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More than half of Obamacare co-ops go belly up

 

More than half of Obamacare’s nonprofit co-op plans have now failed, prompting House Republicans Tuesday to label the program a disaster that is fleecing taxpayers out of billions.

 

Consumers Mutual Insurance of Michigan posted notice that it would not sell plans for 2016, making it the 12th of Obamacare’s initial 23 co-ops to close shop, despite early hopes the program would create competition and slash prices under President Obama’s signature overhaul.Scissors-32x32.png

 

http://www.washingtontimes.com/news/2015/nov/3/more-half-obamacare-co-ops-go-belly/

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Obamacare Loses Big In Kentucky
John Fund
November 4, 2015

Yesterday’s election was a clear black eye for Democrats and President Obama. The Washington Post headline they will wake up to today is: “From coast to coast, conservatives score huge victories in off-year elections.”

The biggest victory came in Kentucky where every pollster had shown Democrat Jack Conway beating Republican Matt Bevin. Democrats declared the race a referendum on Obamacare. Retiring Democratic Governor Steve Beshear told the Washington Post yesterday that the key issue in the race of Bevin’s pledge to eliminate or modify the state’s Medicaid expansion and follow that up by abolishing abolish the state-based exchange, called Kynect.

With the expansions, one out of four Kentuckians now receive government-paid health care. You’d think that would represent an overwhelming constituency against any change, but not in all cases. But modernhealthcare.com reported that:

“Even some residents who are enrolled in the expanded Medicaid program or an exchange plan supported Bevin. Stanley and Deborah Harp, who own a business in Georgetown, Ky., were among Americans who saw their policies canceled after the Affordable Care Act went into effect. They now qualify for Medicaid, but they aren’t happy about it and they voted for Bevin. “We’ve had the same doctor groups for the past 20 years who have our history, our kids had as pediatricians,” said Deborah Harp.”

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Remember when Barry, Nancy & Harry told us we'd love the ACA once we got to know it? (how shall I put this) WRONG!!!!!

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Obamacare Is Dead…It doesn’t work because it couldn’t work.

By Curt 4 Comments

 

Wed, Nov, 4th, 2015

129 views

Kevin D. Williamson:

 

Regardless of whether there is a President Cruz or a President Rubio in January 2017, regardless of the existence or size of a Republican majority in Congress, the so-called Patient Protection and Affordable Care Act (ACA) has failed. The grand vision of an efficient pseudo-market in health insurance under enlightened federal management — the heart of Obamacare — is not coming to pass. Obamacare, meaning the operating model that undergirded the law that Congress passed and President Barack Obama signed with great fanfare — is dead, and it will not be revived. What remains is fitful chaos.

 

A brief refresher:

 

The fundamental problem with ACA is that under it, insurance ceases to be insurance. Insurance is a prospective financial product, one that exploits the mathematical predictability of certain life events among very large groups of people — out of 1 million 40-to-60-year-old Americans, x percent will get in car wrecks every year, and y percent will be diagnosed with chronic renal failure — which allows actuaries and the insurance companies that employ them to calculate premiums based on risk, thus funding the reimbursement of certain expenses incurred by the insurance pool’s members Scissors-32x32.png http://www.floppingaces.net/most-wanted/obamacare-is-dead-it-doesnt-work-because-it-couldnt-work/

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Obamacare Is Dead…It doesn’t work because it couldn’t work.

 

 

 

Wouldn't that depend on what it was designed to do? I mean it may be working just the way it was meant to.

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Not your imagination: ObamaCare premiums shot up by double digits for 2016
Ed Morrissey
November 5, 2015

This may seem redundant, given all of the attention to huge price spikes in the ObamaCare exchanges in states like Minnesota (between 34-50% for most plans) and Mississippi (over 60%). Even CBS News has begun to wake up to the rapidly escalating costs of insurance in the so-called Affordable Care Act exchanges. Yet ObamaCare advocates argue that these price explosions are localized and not indicative of the overall direction of premium prices in 2016.

A new study shows that the price hikes are not just localized or anecdotal. Megan McArdle picks up on an analysis by Avalere that shows an average 13% increase in the cheapest plans for subsidized mandatory coverage. McArdle writes that this may not be the “death spiral” that critics predicted, but it’s an indication that the assumptions made by ObamaCare’s architects turned out to be dead wrong (via Guy Benson):

It’s also worth pointing out that these are the plans usually purchased by those of modest means or healthier individuals who don’t plan to utilize insurance as often as others. The major price escalation hits these consumers hardest, which makes the “affordable” tag on the ACA a little ironic.

 

McArdle believes that the premium price spikes alone don’t indicate the beginning of a death spiral in ObamaCare. The ongoing collapse of ObamaCare co-ops tell a different tale. Twelve of the 23 co-ops funded by HHS to replace the “public option” and supposedly provide low-cost choice for consumers have failed this year, and nine of those have stopped selling insurance in just the past six weeks. In my column for The Fiscal Times, I argue that this is a harbinger of a broader disaster:

 

(Snip)

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Another Obamacare Failure: $1.23 Billion Taxpayer Funds Sunk in Failed Co-Ops

 

A total of $1.23 billion in federal taxpayer dollars has now been sunk in 12 of 23 co-ops created under Obamacare that have gone out of business, representing another Obamacare failure, lawmakers say.

Co-ops in Arizona and Michigan went out of business last week, adding themselves to the 10 that have already failed in Utah, Kentucky, New York, Nevada, Louisiana, Oregon, Colorado, Tennessee, South Carolina, and a co-op that served both Iowa and Nebraska.

Experts and congressmen say the co-ops failed because of artificially low premiums, strict regulations, and too many people requiring payouts.

“This was set up for failure from day one,” said Rep. Chris Collins (R., N.Y) at a House Energy and Commerce committee hearing evaluating the failed-co-ops on Thursday. “Insurance companies knew it was going to fail, they released a product that was underpriced, they could not make money.”Scissors-32x32.png

 

http://freebeacon.com/issues/another-obamacare-failure-1-23-billion-taxpayer-funds-sunk-in-failed-co-ops/

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Governor-elect Bevin set to roll back Obamacare in Kentucky

 

What Kentucky’s Democratic governor has done to implement Obamacare may soon be undone by the Republican governor-elect.

 

Matt Bevin, who defeated Kentucky Attorney General Jack Conway 53 percent to 44 percent Nov. 3, campaigned on uprooting Gov. Steve Beshear’s Obamacare exchange and Medicaid expansion.

 

Without support from a divided Kentucky Legislature, Beshear created a state-run Obamacare exchange and opted in to Obamacare’s expansion of Medicaid to working-age adults with no kids and no disabilities.

 

Praising Beshear during his 2014 State of the Union speech, President Obama said the governor was “like a man possessed” when it came to implementing Obamacare — regardless of opposition from state legislators.

 

Unfortunately for Obama and fans of his unpopular health insurance law, Beshear’s unilateral actions leave the state’s two biggest pro-Obamacare decisions open to reversal from Bevin.Scissors-32x32.png

 

http://watchdog.org/246281/bevin-roll-back-obamacare-kentucky/

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  • 2 weeks later...

Obamacare Architect: Okay Fine, Our Law Isn't Controlling Costs
Guy Benson
Nov 24, 2015

You remember Dr. Ezekiel Emanuel, don't you? He's the brother of Rahm, who played an instrumental role in crafting and promoting Obamacare -- and who occasionally lets the truth slip regarding its myriad broken promises. Here he is admitting what has become painfully obvious: The so-called 'Affordable' Care Act that he helped design, and that Democrats marketed to the public as a cost-reduction measure, is failing by its own standards. "We need to focus on cost control," means "the law isn't controlling costs." The doctor is correct on this point:


With the open enrollment deadline for Obamacare looming next month, one of the chief architects of the president's health law said Friday the plans offered on government-run exchanges need to be more affordable in order to boost participation rates. High-deductible plans are part of the problem, Dr. Ezekiel Emanuel added..."Even though I am a liberal, I think we really have to focus on cost control. Affordability is absolutely critical across the board, because if we don't have affordable plans we are not going to get universal coverage. They are intimately linked," said Emanuel...He did acknowledge: "We've overplayed the high-deductible plans. People are feeling this is less and less insurance. And just more and more, 'I'm paying out of my pocket.'"

 

 

With rates rising substantially across most of the country, consumers are also being pummeled with climbing out-of-pocket costs. They're forking over a fortune before the coverage they're paying into each month even kicks in at all -- and when it finally does, many are discovering narrow networks and difficulty securing actual care. It's telling that Obamacare godmother and cheerleader Hillary Clinton feels compelled to offer new healthcare affordability proposals. Democrats can repeat the empty "it's working" slogan all day long; their presumptive nominee's actions tell the real story. Last week, America's largest private insurer signaled that it is seriously considering pulling out of the Obamacare market, citing major losses that could prove unsustainable over time. This is a big deal, and Philip Klein has been all over it:

 

(Snip)

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How Obamacare Could Limit Insurance Options for Americans in These 34 States

 

More than 500,000 consumers who purchased plans from UnitedHealthcare on Obamacare’s exchanges may be forced to change insurers and select new coverage in 2017, despite the insurance giant’s decision to expand into 34 states this year.

 

Last week, UnitedHealthcare, the largest insurer in the U.S., told shareholders it was considering pulling out of the state- and federally run exchanges in 2017, with a decision likely to come in early 2016, the company said.

 

UnitedHealthcare announced it will evaluate whether the plans it offers on the exchanges can remain viable, according to a press release from its parent company, UnitedHealth Group. However, the possibility of the insurance giant leaving Obamacare’s health insurance exchanges could have a significant impact on consumers purchasing insurance in the 34 states where UnitedHealth sells plans.

 

“In recent weeks, growth expectations for individual exchange participation have tempered industry wide, co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated, so we are taking this proactive step,” Stephen Hemsley, chief executive officer of UnitedHealth Group, said in a statement Friday.Scissors-32x32.png

 

http://dailysignal.com/2015/11/25/how-obamacare-could-limit-insurance-options-for-americans-in-these-34-states/

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Argument preview: Justices to consider whether ERISA preempts state health-care databases

By Ronald Mann on Nov 25, 2015 at 2:58 pm

 

Gobeille v. Liberty Mutual Insurance Company will never get the press scrutiny of King v. Burwell, but at heart it considers much the same policy question: to what extent does federal law facilitate the centralized management of health care? To be sure, the precise issue in the case is quite distinct from the weighty questions the Court considered inKing. The question here is whether the Employee Retirement Income Security Act of 1973 (ERISA) preempts state statutes that provide for “all payer” health care databases – designed to provide comprehensive state-level information about the distribution of health care services provided in the state and the costs of providing them.

 

The statute at issue here authorizes Vermont’s database, but there is nothing unusual about Vermont’s program; more than a dozen states manage similar databases. Scissors-32x32.png

 

http://www.scotusblog.com/2015/11/argument-preview-justices-to-consider-whether-erisa-preempts-state-health-care-databases/

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OBAMACARE ENDURES THE DEATH OF A THOUSAND FACTS

The remorseless laws of economics are cutting it to pieces.

 

By David Catron 11.23.15

 

Until the 19thcentury, the Chinese practiced a method of torture called lingchi. Better known as “death by a thousand cuts” it involved slicing small pieces of flesh from a victim’s body, one by one, so that death was both protracted and utterly excruciating. This is what the realities of economics are doing to the Patient Protection and Affordable Care Act. The authors of health care “reform” believed they could ignore the dismal science. The laws of economics have rewarded this hubris by ruthlessly inflicting fact after agonizing fact on Obamacare. And, like all lingchi victims, it will eventually succumb.

 

Moreover, this is becoming obvious to all but the most obtuse of the law’s apologists. In fact, it has been conceded by strongholds of Obamacare supporters like the Washington Post, the New York Times, and even the Huffington Post. The latter publication, for example, carried a column late last week titled, “Why Obamacare Will Fail.” And, as surprising as it was to find such an article in this notorious purveyor of White House propaganda, Scissors-32x32.png

http://spectator.org/articles/64741/obamacare-endures-death-thousand-facts

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  • 2 weeks later...

OBAMACARE REPEAL BILL: MORE THAN MERE SYMBOLISM

 

It will remind voters that the Democrats don’t give a damn what they want.

 

The President, congressional Democrats, and their media allies have attempted to portray the partial Obamacare repeal passed by the Senate last Thursday as cynical GOP posturing. As MSNBC phrased it, “It’s not exactly a secret that when congressional Republicans vote to repeal all or part of the Affordable Care Act… it’s not because they intend to succeed.” The Democrats want to convince the electorate that the Senate bill is just another “symbolic” GOP repeal effort. But it isn’t. This measure will actually reach Obama’s desk, which will force him to once again tell the voters to “go to Hell.”

 

The Senate bill and the President’s inevitable veto will constitute a practical and timely demonstration of his party’s contempt for representative democracy. It will remind the voters that the Democrats have no intention of heeding their will on health care reform or anything else. Voter anger about Obamacare has already cost the President’s party its majorities in both houses, and it is undeniably more unpopular than ever. Yet, not only has President Obama promised to veto the repeal bill, the presumptive Democrat presidential nominee has publicly pledged to be equally unresponsive to the will of the people.

 

Such arrogance would be justified, according to the perverse logic of liberalism, if Obamacare was working. But only a con artist or someone with brain damage would make that claim. The Democrats promised that Obamacare would “bend the cost curve down.” But the “Affordable Care Act” has rendered health care less affordable. The Centers for Medicare and Medicaid Services (CMS) reports that a decade-long downward trend in health care inflation came to a halt during the first year Obamacare took effect: “In 2014, U.S. health care spending increased 5.3 percent following growth of 2.9 percent in 2013.”Scissors-32x32.png

 

http://spectator.org/articles/64862/obamacare-repeal-bill-more-mere-symbolism

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Key Obamacare official faces questions over use of funds

 

House lawmakers are expected to grill a top administration official on Tuesday over whether state Obamacare exchanges are using taxpayer-funded grants properly.

The House Energy and Commerce's Oversight Subcommittee will hold a hearing Tuesday featuring Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, the agency tasked with overseeing Obamacare. The hearing is the second in a series on federal oversight of state-based exchanges.

"CMS oversight has been woefully sloppy at best and willfully ignorant at worst with obvious spending abuses costing taxpayers billions and counting," Rep. Tim Murphy, R-Pa., told the Washington Examiner Monday. Murphy is chairman of the oversight subcommittee.Scissors-32x32.png

 

http://www.washingtonexaminer.com/key-obamacare-official-faces-questions-over-use-of-funds/article/2577827

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CBO: 2 million jobs' worth of hours lost under ObamaCare

 

ObamaCare will force a reduction in American work hours — the equivalent of 2 million jobs over the next decade, Congress’s nonpartisan scorekeeper said Monday.

 

The total workforce will shrink by just under 1 percent as a result of changes in worker participation because of the new coverage expansions, mandates and changes in tax rates, according to a 22-page report released by the Congressional Budget Office (CBO).

 

“Some people would choose to work fewer hours; others would leave the labor force entirely or remain unemployed for longer than they otherwise would,” the agency said in its latest analysis of the now five-year-old law.

The CBO is not predicting that employers will fire millions of workers or reduce hours because of the law, but that the law changes incentives over the years for the workers themselves both in part-time and full-time positions.

 

That could mean that older Americans who wish to retire but have remained in the workforce solely for employer health benefits could opt to leave their jobs.

 

Republicans were quick to seize on the report, which provides an update through 2025.

 

“When the President’s health law hurts the labor force at the same time it increases healthcare premiums and taxes, it’s clear the law is not working for the American people,” said Senate Finance Committee Chairman Orrin Hatch (R-Utah.).

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http://thehill.com/policy/healthcare/262360-cbo-projects-2-million-fewer-jobs-under-obamacare

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Lone profitable ACA insurance co-op losing millions

TOM MURPHY

Dec 10 2015

 

The lone health insurance cooperative to make money last year on the Affordable Care Act's public insurance exchanges is now losing millions and suspending individual enrollment for 2016.

 

Maine's Community Health Options lost more than $17 million in the first nine months of this year, after making $10.9 million in the same period last year. A spokesman said higher-than-expected medical costs have hurt the cooperative.

 

The announcement casts further doubt on the future of the cooperatives, small nonprofit insurers devised during the ACA's creation to inject competition in insurance markets. These co-ops immediately struggled to build their businesses. A dozen of the 23 created have already folded.

 

(Snip)

 

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H/T Hot Air

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Lyle Denniston Independent Contractor Reporter

Posted Fri, December 11th, 2015 6:07 pm

 

The legal fate of Obamacare: Round 4

NOTE TO READERS: Next week the blog will publish a multi-part symposium on the seven cases the Supreme Court will hear this Term on the latest challenge to the Affordable Care Act: a protest by religious non-profits arising from the law’s birth-control mandate. This post provides an overview of the cases and the main arguments by the two sides. The following posts will provide varied perspectives on the significance of the controversy.

——————–

Assuring that the legal threats to the new federal health care law will continue to unfold in the final year of President Barack Obama’s term in the White House, the Supreme Court turns next to the plea of religious non-profit schools, colleges, hospitals and charities to be exempted from any role in carrying out the law’s promise of free contraceptives to working women and some students. It is a high-stakes sequel to the 2014 ruling giving some for-profit companies an exemption from that mandate, and it probably will further clarify church-state relationships in America.

 

This will mark the fourth time the Court has taken up a challenge to the Affordable Care Act: Scissors-32x32.png

 

http://www.scotusblog.com/2015/12/the-legal-fate-of-obamacare-round-4/

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Rubio Scores a Direct Hit on Obamacare

 

Since it fell into GOP hands, the House of Representatives has voted more than 50 times to repeal Obamacare, in whole or in part. The exercise was worthwhile, because political theater is sometimes worthwhile. But with the Senate in the way, and a presidential veto as certain as night follows day, there was never much hope that a “frontal assault” on the fortress walls would succeed.

 

As Senator Marco Rubio has shown, a careful study of how Obamacare works suggests a much better strategy: Besiege the program until it surrenders. Establish a cordon around Obamacare so that it can’t expand, cut it off from its main sources of support, and use sappers to undermine the defenses.

 

Obamacare has the same congenital weakness as every other law that seeks to “guarantee” issuance of health insurance to all who apply for it: It starts by imposing huge losses on insurance companies that are absolutely vital for the law to function properly. Any program of guaranteed issuance must therefore find a way to subsidize the participation of insurance companies, or they will exit the market altogether. Once insurance companies exit the market, the jig is up, and there is no choice but to repeal the law.

 

That’s precisely what happened at the state level in the 1990s, after the failure of the Clintons’ health-reform effort. Some eight states adopted guaranteed-issue reforms for the “individual market” (the 10 percent or so of health insurance not purchased through employers and hence not federally regulated). Almost immediately, those laws produced what health-care analysts call “adverse-selection death spirals”: Increasing numbers of healthy people chose to wait until they were sick to get health insurance. Despite provisions that allowed insurers to exclude those with pre-existing conditions, the per-unit costs of health insurance rose dramatically, driving premiums sky-high, thus driving still more healthy people off the insurance rolls. Health insurers quickly exited the market.Scissors-32x32.png

 

http://www.nationalreview.com/article/428640/rubio-obamacare-direct-hit

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Insurers get big reprieve in spending deal

 

Insurers got a much-desired reprieve from an unpopular tax in Congress' $1.9 trillion spending deal and tax break package, but no bailouts for Obamacare.

 

The measures in the package, released early Wednesday, come at a time when some insurers are debating whether to stay in the Obamacare marketplaces.

 

Insurers got some bad, but not surprising, news as Congress once again made a safety net program for Obamacare insurers called "risk corridors" budget neutral, meaning the Obama administration can pay insurers only as much as it takes in.Scissors-32x32.png

 

http://www.washingtonexaminer.com/insurers-get-big-reprieve-in-spending-deal/article/2578583

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Hillary on Obamacare: ‘Unfortunate Incentives That Discourage Full-Time Employment’
Jim Geraghty December 18, 2015

 

On Wednesday, Hillary Clinton belatedly acknowledges that Obamacare, a.k.a. the Affordable Care Act, gave employers an enormous incentive to move their employees from full-time to part-time:

 

(Snip)

 

 

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Oh if only someone had warned us!...wait....Someone did.

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Obamacare Loses the Bet

BY CHARLIE MARTIN DECEMBER 18, 2015

 

Sometimes I hate being right.

 

I've been talking about the "arithmetical absurdity of Obamacare" and the common version of health "insurance" for nearly eight years. Not long ago, I pointed out that the insurance that was available from the exchanges, for individuals, was excessively expensive and had poor coverage.

 

Since then, about half of the Obamacare co-ops -- nonprofit insurance companies created with startup funds from the government to provide insurance on the exchanges -- have failed and either have gone out of business, or are in the process of doing so. What's killing these co-ops? Oh, there's some fraud, and there's some Democratic Party cronies who made some big money, but what's really killing the co-ops is something much more unrelenting than fraud, much more insidious than cronyism.

 

What's killing the co-ops? Arithmetic. Scissors-32x32.png

https://pjmedia.com/blog/obamacare-loses-the-bet

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Obamacare glitches are back
Tami Luhby
Dec. 20 2015

Washington (CNN)Two years ago, the Obama administration called the near-total, initial meltdown of the Obamacare federal exchange a technical "glitch." The term was widely ridiculed at the time, especially since it took weeks to fix the exchange's website, healthcare.gov.

At Saturday night's Democratic debate, front-runner Hillary Clinton called soaring health care costs and deductibles "glitches" resulting from the Affordable Care Act.

Her comments prompted quick reaction on Twitter, and RNC Chairman Reince Priebus said, "Clinton's claim that premium hikes from Obamacare are just 'glitches,' was an insult to working families struggling to pay their health care bills."

 

(Snip)

 

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ohmy.png

Many See I.R.S. Penalties as More Affordable Than Insurance
ABBY GOODNOUGH
JAN. 3, 2016

WASHINGTON — Clint Murphy let the deadline for getting health insurance by the new year pass without a second thought.

Mr. Murphy, an engineer in Sulphur Springs, Tex., estimates that under the Affordable Care Act, he will face a penalty of $1,800 for going uninsured in 2016. But in his view, paying that penalty is worth it if he can avoid buying an insurance policy that costs $2,900 or more. All he has to do is stay healthy.

“I don’t see the logic behind that, and I’m just not going to do it,” said Mr. Murphy, 45, who became uninsured in April after leaving a job with health benefits to pursue contract work. “The fine is still going to be cheaper.”

Two years after the Affordable Care Act began requiring most Americans to have health insurance, 10.5 million who are eligible to buy coverage through the law’s new insurance exchanges were still uninsured this fall, according to the Obama administration.

 

(Snip)

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