Obamacare Is Collapsing in Slow Motion and Both Parties Are Letting It Happen

Let’s Call This What It Is

Health insurance premiums on ACA plans are going up again in 2027. Not a little. A lot. And the people running Washington on both sides of the aisle are going to stand in front of cameras and pretend to be outraged while cashing checks from the very industry causing the problem.

Here are the numbers:

• Sentara in Washington state wants a 28 percent increase after already hiking rates 35 percent for 2026
• Blue Cross Blue Shield of Illinois is requesting 15 percent on top of a 28 percent prior-year hike
• ACA enrollment dropped from 22.1 million to 19.2 million as people bailed on unaffordable plans
• The risk pool is deteriorating because healthy people are leaving and only the sickest remain

This is a textbook death spiral. And it was predictable from the start.

The Incentive Structure Is Broken by Design

The pre-existing condition mandate sounds compassionate. But the way it was implemented created a rational economic reason for healthy people to skip coverage entirely and only enroll when they get sick. That is like calling your insurer after your house is already burning down and asking for fire coverage.

When healthy people exit the pool, costs for everyone remaining go up. Then more healthy people leave. Repeat until the system implodes. This was not a mystery. This was math.

Meanwhile, physicians are earning less and drowning in administrative paperwork. We supposedly have technology that should make healthcare more efficient. Yet costs keep rising. So who exactly is extracting all that money from the system? It is not your doctor. And it is definitely not you.

Both Parties Had a Solution Available

A high-risk pool approach, where the government directly subsidizes coverage for people with serious pre-existing conditions, could have solved the hardest part of this problem without wrecking incentives for everyone else. It was a workable answer. It did not happen because it would have reduced the leverage that insurance companies, hospital systems, and pharmaceutical companies hold over the entire political system.

Republicans spent years promising a healthcare alternative. When they had the opportunity, nothing concrete emerged. Democrats built a system that created a subsidy dependency masked by COVID-era spending, and now that the subsidies are gone the structural rot is visible.

Both parties take insurance money. Both parties have failed on this. That is the story.

The Ground-Level Damage Is Real

I will give you a real-world example because I live it. Here in Florida, population is booming. Doctors are not. Finding a primary care physician with actual availability is a serious challenge. I have had physicians contact me about transitioning out of medicine entirely because the paperwork and administrative burden have made practicing medicine miserable.

When your doctors are looking for the exit, the system is in trouble.

Premiums are going up. Access is going down. The risk pool is getting sicker. And your elected officials are busy fundraising from the industry that benefits from every single one of those trends.

Budget accordingly. Because nobody in Washington is riding to the rescue on this one.