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Can Obamacare survive dropping enrollment?

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Obamacare premiums are rising. Enrollment is plummeting, especially in red states. As health care costs increase, more Americans are choosing to go without expensive coverage, which could lead to a “death spiral” for a program originally intended to expand healthcare affordability and accessibility.

What did the commentators say?

Middle-class Americans are “straining to pay” premiums for Obamacare, said The Associated Press. More than 2.5 million people dropped their coverage during the last year, and the problem is likely to get worse as insurers in the program’s marketplace are now seeking a “second straight year of double-digit premium hikes.” Insurers attribute the rising costs to the expiration of COVID-era federal subsidies and tough new eligibility requirements imposed by the Trump administration. That may be leading to a vicious cycle. Healthier people are choosing to forgo coverage, leaving Obamacare insurers with a “sicker patient population that relies more heavily on insurance.” That could drive additional premium hikes for those who remain.

The pandemic-era Obamacare subsidies “overwhelmingly benefitted red states,” said Axios. Those are also the states that are seeing the biggest fall-off in enrollees since “Congress let the subsidies expire” this year. Ohio and Oklahoma “lost nearly a third of their Obamacare enrollment” while Indiana, Michigan, Mississippi and Louisiana “also had deep coverage losses.”

“It’s almost certain that things will get worse,” Michael Hiltzik said at the Los Angeles Times. President Donald Trump’s 2017 attempt to repeal Obamacare failed, so his administration has now “implemented changes” to the program that “reduce access to healthcare and increase paperwork.” Instead of ending the program, Republicans are “eliminating or hamstringing all the elements that have bolstered its popularity.” The GOP never made good on its promise to end Obamacare, but the latest statistics show that for “millions of Americans, repeal indeed has happened.”

Obamacare is a “slow-rolling failure that Congress has propped up with subsidies,” said The Wall Street Journal editorial board. That is evident in the enrollment numbers. The Department of Health and Human Services reported that its “efforts to crack down on fraud” kept 2.9 million people from getting coverage they were ineligible to receive. Republicans should pass legislation that serves as an “off-ramp to better insurance.”

What next?

The exodus of enrollees will leave insurers with a “smaller, sicker pool of people” to cover, Lisa Jarvis said at Bloomberg. That threatens to create a “death spiral” that could leave “some parts of the country” with no coverage options and many Americans with “impossible choices about their household budgets.”

Rising Obamacare premiums are “adding fuel to Democratic attacks over affordability” in the midterm elections, said The Hill. The president and congressional Republicans are “squarely to blame” for the rising healthcare costs, NC Rapid Response Director Kendall Witmer said in a statement to the outlet. Obamacare survives for now, said Ceci Connolly, CEO of the Alliance of Community Health Plans, “but it is heading in a direction of instability.”

Rising premiums, expired subsidies lead to an exodus