Â鶹ŮÓÅ

Open enrollment for the Affordable Care Act’s third year began on Sunday amid fierce criticism from the law’s detractors. As usual, the critics vastly overstate their case — and, as usual, that is no reason for Obamacare’s allies to ignore the serious challenges it still faces. The landmark health reform is working, but it still hasn’t stabilized. (11/3)

For the press, the debate about Obamacare is over. There may be a few proverbial Japanese soldiers wandering on isolated islands yammering on about the failure of Obamacare, but word will eventually filter down to them, too. This assumption is so deeply embedded that it is impervious to new evidence that Obamacare is an unwieldy contraption that is sputtering badly. Yes, Obamacare has covered more people and has especially benefited those with pre-existing conditions (to be credible, Republican replacement plans have to do these things, as well), but the program is so poorly designed that, surely, even a new Democratic president will want to revisit it to try to make it more workable. (Rich Lowry, 11/3)

[A] consulting company, Avalere Health, has provided at least slightly more data than we had before, supplementing the administration’s release of the information on benchmark plans by looking at the cost of the cheapest Bronze and Silver policies. It’s still far more limited than one would like, but looking at those rates does give us additional information. The biggest thing they tell us is that ... the whole bottom of the market is undergoing a fairly massive repricing. In most states, the cost of the cheapest Silver plan, relative to the cheapest one last year, rose even more than the benchmark rate. And in most states, the cost of the cheapest Bronze plan went up by more than the cost of the cheapest Silver plan. (Megan McArdle, 11/3)

Sabrina Corlette is a senior research professor at the Georgetown University Center on Health Insurance Reforms. She previously worked as the director of health policy programs for the National Partnership for Women & Families. With the Affordable Care Act's insurance marketplaces beginning their third open enrollment this week, RealClearHealth talked to Corlette about what's working, what's not working, what the marketplaces' risk pools look like, and what should be on the agenda of a new administration in 2017. (11/4)

Last week we showed how, two years into Obamacare, there are still millions of uninsured Americans. The article and maps, which showed where uninsured Americans still live, generated many comments and questions. Here, we respond to a few of them. (Quoctrung Bui and Margot Sanger-Katz, 11/3)

Montanans showed flexibility, creativity and persistence as they worked to provide more health care coverage to tens of thousands of Montanans, including low-wage earners. It’s good news that Montanans from both political parties came up with the state’s own version of expanding the federal Medicaid program for folks with lower incomes. There was a gap between Montanans who already have health insurance coverage, and Montanans who have so little income they qualified for Medicaid outright. (11/3)

Hillary Clinton has denounced Gov. Terry Branstad’s plan to privatize administration of the state’s $4.2 billion Medicaid program. “I believe advocates have raised some legitimate concerns about the companies that were awarded contracts that have faced accusations of mismanagement," the Democratic presidential candidate said last month. That only scratches the surface of problems with the governor's plan, from an initial state bidding process that increasingly reeks of scandal to using precious public health dollars to pad the profits of private insurers. A presidential candidate is weighing in on a Medicaid disaster in the making here. Where is the current president? Where is his appointee, Sylvia Burwell, the director of the U.S. Department of Health and Human Services? Are they paying attention to what is going on in Iowa? Do they realize the vast majority of Iowans oppose what the governor is pursuing? Are they going to stop him? (11/3)

One of the less-noticed provisions of the Affordable Care Act requires calorie labels at all chain restaurants and similar retail food establishments, following similar efforts in New York City and elsewhere. A new study raises doubts about whether those labels will make much difference to public health. The right response isn't to abandon the effort, but to improve it, and consider new approaches. (Cass R. Sunstein, 11/3)

This is a nation built on individual rights. But when it comes to the end of life, the lack of medical information can make it difficult to make personal decisions. Medicare’s decision to pay for end-of-life counseling for terminally ill patients is a positive step that can help people take control of their health-care choices. This is both a no-brainer and a delicate balancing act. (11/3)

Now it's Ohio lawmakers' turn to deal with marijuana legalization. I know this might seem counterintuitive after Ohio voters just soundly rejected Issue 3, a proposed amendment to the state constitution that would have legalized marijuana for medical and recreation use. But efforts to legalize marijuana are not going away. And Tuesday's results should not be seen as a legislative victory or even an honest reflection of Ohio voters' views on legalization. (Mark Naymik, 11/3)