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More than 250,000 people in North Carolina are losing the health plans they bought under the Affordable Care Act because two of the three insurers are dropping out — a stark example of the disruption roiling marketplaces in many parts of the country. The defections mean that almost all of the state, from the Blue Ridge to the Outer Banks, will have just one insurer selling ACA policies when the exchanges open again for business in November. The remaining company, Blue Cross Blue Shield of North Carolina, agonized over whether to leave, too. Instead, it is raising its rates by nearly 25 percent. (Goldstein, 10/14)

Doctor and hospital switching has become a recurring scramble as consumers on the individual market find it difficult or impossible to stay on their same plans amid rising premiums and a revolving door of carriers willing to sell policies. The instability, which preceded the health law, is intensifying in the fourth year of the Affordable Care Act’s marketplaces for people buying insurance directly instead of through an employer. “In 2017, just because of all the carrier exits, there are going to be more people making involuntary changes,” said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation, a New Jersey philanthropy. “I would imagine all things being equal, more people are going to be disappointed this year versus last year.” (Rau, 10/17)

States where insurers underpriced individual plans in the early years of the federal healthcare exchanges are posting sharply higher premiums for next year, although subsidies will moderate the increases for many low- and moderate-income consumers. Illinoisans learned Friday that people buying insurance on the state's exchange will face steep price increases for next year. The Illinois Department of Insurance published an analysis of 2017 health plans Friday based on final price increases approved by state and federal regulators. Statewide, the average rate increase for the lowest cost "silver" plan is 45%. (Silver is a label of a middle-tier plan that's been a popular choice.) (10/15)

The individual health insurance marketplace is not a small capillary for Blue Cross and Blue Shield of Arkansas, the dominant insurer in the fourth-poorest state in the country. It's a main artery. And the good news for the Arkansas Blues is that the individual market—a “disaster” according to presidential hopeful Donald Trump—is pumping black ink, not the blood-red ink reported by some insurers selling individual plans on the Affordable Care Act exchanges across the country. ... Next door, in Tennessee, a much different story unfolded. Blue Cross and Blue Shield of Tennessee posted an underwriting loss of $195.7 million on $866.4 million of revenue in 2015 just from its individual plans—a negative margin of almost 23% that gets worse when administrative expenses are tacked on. (Herman, 10/15)

House Republicans are wading into the heated legal battle between the White House and several insurers that claim they are owed money under ObamaCare. The House GOP announced Friday it has filed a brief in a major ObamaCare lawsuit that involves a multibillion-dollar shortfall in a fund intended to cushion health insurers from financial losses under the law. The $5 billion class-action lawsuit was filed by the now-shuttered insurance company called Health Republic of Oregon. It is one of about a dozen companies that have sued over the still-delayed payments, which they say crippled their businesses. (Ferris, 10/14)

Health insurers do not want congressional Republicans to block potential settlements of their lawsuits against the administration involving Obamacare, according to Marilyn Tavenner, president and CEO of America’s Health Insurance Plans. Within the Republican conference, options are being discussed about how to stop any lawsuit-related payments to the industry. Conservative groups are loudly urging against such settlements. (Owens, 10/14)

While the Affordable Care Act cut the number of uninsured by about 32%, millions of immigrants don't qualify for the law's coverage expansions. They still have few options for primary care. People living in the U.S. without authorization can't buy health insurance from the ACA's exchanges and aren't eligible for Medicare, Medicaid or the Children's Health Insurance Program. Even lawful residents who have lived in the U.S. for less than five years can't get Medicaid or CHIP. Local governments in areas with large numbers of new immigrants have stepped up to become their health safety net. (Johnson, 10/15)