Obamacare had a very rough week last week, with all insurers abandoning most of Iowa and another dropping out of the program in Virginia. But I missed the report from last week on the "death spiral" that insurers are worried about in Maryland. (Republican staffers on Capitol Hill, as it happens, did not miss it.)

The largest insurer in the Mid-Atlantic region — my former insurer, CareFirst Blue Cross Blue Shield — has requested permission to raise its premiums by large double-digit percentages. And their CEO had some words with the Washington Post's wonk blog that demonstrate this is due to the law's features, not the bugs related to Republicans potentially changing it.

Projecting that by year's end the company will have lost a total of $600 million since it started selling plans in the marketplaces four years ago, CareFirst Blue Cross Blue Shield is requesting a greater than 50 percent rate increase in Maryland, a 35 percent increase in northern Virginia and a 29 percent increase in D.C.

"What we're seeing is greater sickness levels. The pool of beneficiaries is becoming sicker, in part because healthier people are not coming in at the same level we hoped," said Chet Burrell, chief executive of CareFirst, which insures about 215,000 people through the marketplaces set up by the Affordable Care Act in all three states.

You might almost say that this — the same exact thing causing all the recent market exits by insurers — is exactly what Obamacare's opponents warned about. Because it is. Unless you make little enough to be eligible for a large subsidy (but too much for Medicaid), or get insurance through work, your monthly premium on the individual market may soon resemble a rent payment in a lower-cost part of America — on the order of $350 to $700 per month, according to the Post. In 2013, before Obamacare, my individual market plan ($2,700 deductible) cost me $62 a month.

And try as you might, you can't blame CareFirst's four-year, $600 million loss in Obamacare's exchanges on the current presidential administration, the Republican-majority Congress that emerged after Obamacare passed and (in the Senate) took effect, nor on Maryland's state government being insufficiently enthusiastic about implementing Obamacare.

To address yet another commonly cited excuse, these rate increase requests were made on the assumption that CareFirst is going to be partially bailed out by federal taxpayers under Obamacare's risk corridor program. Republicans have tried to prevent that bailout, but it remains a matter of controversy that's still bouncing around in the courts. If not for the assumed bailout — or if the bailout doesn't come through — the requests for premium hikes could get even higher, CareFirst CEO Chet Burrell told the Post.

The fact is, Obamacare has a lot of serious structural flaws. It isn't working. President Obama won the debate on some aspects of what health insurance should look like (pre-existing conditions, in particular) as evidenced by the fact that there are many features of Obamacare that Republicans are merely reforming and not dismantling. But if the Republicans weren't overhauling this law right now, President Hillary Clinton would be doing it instead. She might even be considering some of the same fixes, there would just be a lot less hyperbole about her causing people to die.