Let's review. Obamacare has caused average individual market premiums to double on the law's federal exchange since its implementation. Additional sweeping rate hikes are on the way. Choices for consumers are contracting significantly, as insurers abandon the law. And the ranks of those Americans who have chosen to buy coverage through the law's marketplaces -- an already heavily-diminished number (shh, don't tell CBO) -- are thinning. Sticker shock and other factors are yet again leading to significant enrollment attrition. Via CMS statistics and John Sexton:

As of March 15, 2017, 10.3 million individuals had effectuated their coverage for February 2017, meaning that they selected a plan that started in January or February, and had paid their first month’s premium. It is important to note that this number is significantly lower than the 12.2 million (-1.9 million) individuals, as reported in the March Open Enrollment Report. Therefore, in order to get a complete picture about enrollment numbers, it is more accurate to highlight the number of people who actually paid their premiums than those who simply selected a plan. This number will be adjusted for individuals who effectuate their coverage in March 2017...Looking historically at the Patient Protection and Affordable Care Act trends from 2014 through 2017, we also see that a significant number of people who effectuate coverage, do not stay in their plans for the full year. In March of 2016, 10.8 million people had effectuated coverage through the Exchanges, and by the end of the year, only 9.1 million remained. The data on drops in effectuated enrollment shows that, on average since 2014, more than a million enrollees per year have dropped their coverage before the end of the plan year. It is also significant to note that the 10.3 million number reported today falls below the HHS projections for annual 2017 effectuated enrollment.

Sexton notes that potentially hundreds of thousands of last-minute sign-ups could boost this number a bit when the stats are finalized, but draws extra attention to the second bolded excerpt above: "If enrollment this year does continue to follow the pattern it did last year then we would probably expect a final tally of just below 9 million people enrolled by the end of the year." As recently as 2014, the Congressional Budget Office was projecting that 25 million Americans would be signed up for coverage through the exchanges by 2018. Just last year, their prediction was 19 million. Oops. Meanwhile, with individual market consumers residing in roughly one-third of all US counties facing only one "choice" in provider under Obamacare, the number of counties with zero options now numbers in the dozens:

And the price tag for plans keeps heading up, up, up. Via Senate Republicans, behold the 'Affordable' Care Act at work in Texas:



Community Health Choice, a Houston-area insurer, has asked for a 16 percent average rate hike for its 2018 Affordable Care Act exchange plans and warned it might need much more...The deadline for insurers in Texas to file their 2018 rate increase requests with the federal Centers for Medicare and Medicaid Services is Thursday. But even as that deadline ticked closer it was not clear how much other insurers would ask for — or even if they would be participating in the exchange next year.

In Maine:

Health insurers in Maine are again aiming to increase rates for Obamacare plans, with one company seeking an unprecedented 40 percent hike on average in 2018. Insurers had until Friday to file their proposed rates for next year. The higher monthly premiums, if approved by insurance regulators, would affect about 80,000 Maine residents who buy coverage under Obamacare. Even if regulators denied these specific rates, increases of some amount are almost certainly in the offing.

In New Hampshire:

The second-largest insurer in the New Hampshire Obamacare market said his company has requested average rate hikes of 30 percent next year, blaming the increase on two provisions of the health care law — Medicaid expansion and federally imposed risk adjustments...Four insurers are writing policies on the Exchange this year. While state insurance officials have said the market is stable, they have expressed worries about rate increases; on Friday, they announced guidelines for carriers to follow if they want to withdraw from the market.

And in North Carolina:

Blue Cross and Blue Shield, the state’s largest health insurer, is proposing a 22.9 percent rate increase on Affordable Care Act plans in 2018, in what will be the fifth year of the federal health insurance mandate. Steep rate increases have been a consistent feature of Blue Cross’s ACA coverage in North Carolina, and Thursday’s announcement follows a 24.3 percent rate increase this year and a 32.5 percent increase in 2016. The company’s ACA rates have more than doubled since the law made health insurance mandatory for most Americans in 2014. Cigna, which offers ACA plans in five counties in the Triangle, requested a 31.9 percent average rate increase Thursday.

And if liberals object that all of this churn and disruption is attributable to GOP-caused uncertainty (as the Senate tries to hammer out a CBO-reviewed deal behind closed doors before opening up legislation for debate and unlimited amendments), kindly remind them that massive rate and access shock were already the norm before Donald Trump was elected. Please direct them to these numbers, furnished by the Obama administration, from October of 2016 -- when virtually everyone assumed Hillary Clinton would win the election and maintain Obamacare's "stability." Oh, and President Trump tweeted about the enrollment numbers and the slow-motion collapse of Obamacare, earning him a "most false" rating from a comically bad pseudo "fact-checker." Hopeless: