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Eight of the states that will determine the Senate majority in November are likely to see significant reductions in the number of insurers participating in ObamaCare marketplaces. The likely departures of insurers in Illinois, Wisconsin, Florida, Pennsylvania, Ohio, North Carolina, Arizona and Missouri are pushing the healthcare law toward the center of some of the most competitive Senate races in the country. (Ferris, 9/13)

[House Speaker Paul] Ryan is pushing a conservative ACA repeal-and-replace package. Although the speaker remains popular in his sprawling southern Wisconsin district—he won more than 80% of the vote in the Republican primary last month and 63% in his 2014 re-election contest—interviews with constituents and healthcare providers there indicate wariness about his proposals, which likely would drive healthcare policy if Republican Donald Trump is elected president. (Meyer, 9/10)

Republican lawmakers are denouncing the Obama administration after a watchdog report found that the ObamaCare marketplaces remain "vulnerable to fraud." The nonpartisan Government Accountability Office submitted applications from fictitious people for ObamaCare coverage. Those applicants in many cases were approved for coverage, with financial assistance, by the administration. (Sullivan, 9/12)

Rep. Fred Upton (R-Mich.), the chairman of the Energy and Commerce Committee, said the Obama administration must take action to cut down on fraud within the system. ... The agency submitted 15 fictitious applications to the marketplace, and many were approved for coverage and financial assistance by the Obama administration. ... The Centers for Medicare and Medicaid Services told the GAO that “some of GAO’s application outcomes could be explained by decisions to extend document filing deadlines,” according to the report. (McIntire, 9/12)

Health Republic Insurance of New Jersey,  one of 23 nonprofit consumer-operated and -oriented health plans established under the Affordable Care Act, has agreed to be taken over by regulators because of its "hazardous financial condition," the New Jersey Department of Banking and Insurance said Monday. The Newark, N.J., insurer lost $58.96 million in the six months ended June 30 and is expected to have a negative cash position of $17.3 million in January, according to the department's petition for a takeover filed Monday in the Chancery Division of the Superior Court of New Jersey. (Brubaker, 9/12)

ConnectiCare Insurance Co., which already is contesting a Department of Insurance rate decision in court, challenged the matter through a second venue Monday, the department’s administrative appeal process. The Insurance Department immediately began consultations with Attorney General George Jepsen’s office on how to proceed given the two-track challenge. And the state’s health exchange, Access Health CT, announced it would wait temporarily for the insurance department to resolve the rate appeal. (Phaneuf, 9/12)

The cost of health insurance plans offered under the Affordable Care Act will jump 20 percent or more next year under rates to be announced Friday by Maryland regulators. The CEO of Maryland's largest insurer defended the hefty rate increases and said the federal law that expanded health insurance to most Americans needs to be changed if it is to remain sustainable. (McDaniels, 9/12)

Just ahead of the next open enrollment period, the quasi-governmental state agency that runs Maryland's online health insurance marketplace has named Jonathan Kromm as acting executive director. Kromm, currently the deputy executive director of the Maryland Health Benefit Exchange, was tapped by the exchange's board to replace Carolyn A. Quattrocki, who is leaving Sept. 27 to become a deputy attorney general. (Cohn, 9/12)

State regulators have come up empty on a last-ditch effort to recruit more health insurers to the MNsure exchange next year, particularly to sell coverage outside the Twin Cities metro area. Last month, state officials asked potential insurers to specify waivers of state laws or rules that might allow them to newly offer coverage to residents buying insurance outside the seven-county metro area. No applicants surfaced as of Friday's deadline. (Snowbeck, 9/12)