| Here's Why Democrats Aren't Talking About Health Care This Year Let's check in on how the Affordable Care Act is doing out there in the states. Sorry about those premium hikes, Delawareans! Insurance Commissioner Karen Weldin Stewart has approved an average rate increase of 32.5 percent in the individual market for Highmark Blue Cross Blue Shield of Delaware, which has the vast majority of the individual market share in Delaware. That follows an average premium increase of 22.4 percent for individual Highmark plans this year. . . . Aetna Life Insurance Co. received approval for an average 22.8 percent increase in the individual market, while Aetna Health Insurance Co. received an average increase of 23.6 percent. That follows increases of just under 17 percent for this year. Sorry about the lack of options, Iowans! Iowa's state insurance division said residents in 13 rural counties who want to buy subsidized health insurance under the Affordable Care Act will have just one provider to choose from for 2017. Minnesota-based Medica is the only health insurer that has agreed to sell individual policies throughout the state via the Affordable Care Act's online marketplace. The marketplace was touted as a way to encourage competition among health insurers. About 55,000 Iowa residents bought individual health insurance policies for 2016 in the marketplace, and most had incomes low enough to qualify for subsidies, which come as tax credits, the Des Moines Register reported. Sorry you had to pay giant premium hikes and still lost your plan, Tennesseans! After losing nearly $500 million on its individual health plans offered through the Affordable Care Act over the past three years, Tennessee's biggest health insurer is scaling back its participation in the so-called ObamaCare program, even after regulators granted the company a record 62 percent rate hike for next year. BlueCross BlueShield of Tennessee said Monday it is withdrawing its individual exchange plans next year in Memphis, Nashville and Knoxville to help limit the risks of additional losses for the Chattanooga-based insurer. BlueCross will continue to offer individual health plans under ObamaCare in 65 of Tennessee's 95 counties . . . Sorry about the reduced work week and smaller paychecks, Wisconsin! UW-Madison is cutting the work week of its student employees to no more than 29 hours to conform to requirements of the Affordable Care Act, a move some student workers say will make it harder for them to stay in school. "With less hours, many students will have to juggle two jobs, and that will definitely hurt academic success," undergraduate student worker Reid Kurkerewicz said in comments provided by the Student Labor Action Coalition (SLAC). If you liked your plan . . . sorry you can't keep your plan, Nebraskans! Blue Cross Blue Shield of Nebraska has announced that it will not sell individual health insurance in Nebraska on the marketplace under the Affordable Care Act. The decision from the state's largest insurer came on Friday due to the company sustaining losses. The decision will affect roughly 20,000 Nebraskans. New Jerseyans . . . you know the drill. 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. Health Republic, which insures 35,950 people under individual and small-group plans, will continue paying claims this year while under rehabilitation by regulators, but will not offer plans for 2017. Before the Health Republic announcement, 16 of the 23 co-op plans had failed nationwide, as losses mounted. President Obama calls the Affordable Care Act, "a huge success, but it's got real problems." Some might argue those two assessments are contradictory. You Have to Bring Up Your Best Issues Yourself, Donald We will see how Trump performs in Sunday night's second presidential debate. But as I noted yesterday, it's all on him. The audience won't be as big as the first debate's 84 million people, but it will still be large — 60 million? 70 million? If Trump does well, the race is reset again, and he's got a shot. If Trump flops again, it's hard to believe viewership for the third debate will be anywhere near as large. A big measuring stick for Trump's success will be how much he manages to bring up Obamacare and what Americans are experiencing right now. Think about it, Obamacare has achieved one miraculous result: Democrats don't want to talk about health care right before an election. But apparently neither does Trump. Kimberly Strassel metaphorically grabs the GOP nominee by the labels and asks, "How can you not talk about such a gift-wrapped issue?" Mr. Trump is almost entirely, and eerily, silent on the topic. In his prepared speeches, he gives ObamaCare a rote and glancing reference, part of a promise to repeal it. Trump news releases fly daily about the Clintons' corruption and the problems with the North American Free Trade Agreement. But there is nary a whisper about the health-care system that is melting down across the country. Where are the ads? Where is the big speech? Mr. Trump's running mate, Mike Pence, appears to be warming to the issue. He at least warned during Tuesday's vice-presidential debate that a Clinton White House would build ObamaCare into a socialist, "single-payer" system. He has been reassuring conservative voters that a Trump administration would scrap the law's contraceptive mandate. Asked about Mr. Clinton's "craziest-in-the-world" judgment, Mr. Pence quipped that "sometimes with the Clintons, even the truth happens. Those eight words were eight more than Mr. Trump devoted to ObamaCare during his first debate with Mrs. Clinton. During that face-off, the Republican nominee spent a full minute giving the ins and outs of the leverage on his business. He failed to mention the failing health law even once. I'm sure the #NeverTrump crowd annoys the hell out of a lot of Republicans right now. A lot of people would like to see every last conservative put aside differences and unite in a broad, blood-sweat-and-tears, all-hands-on-deck, no-holds-barred, all-or-nothing effort to defeat Hillary Clinton. But that effort requires a candidate who won't fumble the ball at every crucial moment. It doesn't matter what I write or Jonah Goldberg writes or William Kristol writes or what anyone else does if Trump goes up there in front of the biggest audience imaginable and starts ranting about Rosie O'Donnell and spends a week talking about how Miss Venezuela had it coming instead of the actual problems in the lives of the American people. Will he do better Sunday night? Is he practicing and preparing? Last night Trump held a town hall meeting in New Hampshire. Yet even without the duress of an opponent, independent moderators and anything but softball questions from supporters, Trump struggled to drive any type of cohesive message, either about himself as a change agent or Clinton's shortcomings. Instead, he whacked at CNN's John King, CNBC's John Harwood, polling analyst Nate Silver and Republican Sen. Mark Kirk. He digressed about how Hispanics in Nevada would rather be called Latinos. He kept complaining about his microphone at the last debate. For the sake of defeating Hillary, and all the Republican members of Congress who need the presidential race to be at least competitive in order to win, I hope Trump goes out there and really makes a compelling case for himself and against her. But I have absolutely no faith he will do so. ADDENDA: This week's pop culture podcast, there's actual non-vapid news involving Kim Kardashian: What the heck happened in that robbery in that Paris hotel? The NFL contemplates the decline in ratings and I contemplate the Jets' imminent devastating loss to the Steelers; the early intrigue of HBO's Westworld, what it means when a baby has three genetic parents, and remembering childhood crushes. I make a guest appearance on this week's Ricochet Podcast, with Peter Robinson, James Lileks and Rob Long. I can't wait to get my copy of A Torch Kept Lit. | 
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