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First of all, it’s important to understand that there’s no such thing as “Obamacare” as a form of insurance. The name “Obamacare” was given to the Affordable Care Act by Republican opponents of the law. It misrepresents what the law actually is, however. You cannot have “Obamacare” as your insurance.The Affordable Care Act is mostly a series of regulations that private insurance companies have to follow. For example, they can no longer reject a customer because of a pre-existing medical condition, or impose annual or lifetime limits on the amount of care they are willing to pay for. But it also was intended to provide easier access to health insurance for people who do not receive insurance from their employer.See, if you’re unemployed or live below the poverty line, you have Medicaid, which is a government insurance program. If you’re over 65 you have Medicare. If you’re employed and your job provides you with health insurance, then you have private insurance paid for by a mix of contributions from your employer and money deducted from your paycheck. But if you live above the poverty line but have a job that does not offer insurance, then you have to buy it on your own or go without it entirely. About 15–20% of the population fell into this category before the ACA was passed. But buying insurance for yourself was both very expensive and difficult to do; it was hard to know what options were out there for coverage, and so most people who actually bought insurance this way either paid more than they should have because there were few plans available and insurance companies took advantage of how hard it was to even just explore what coverage options were offered by different companies, or they purchased plans that provided very minimal coverage. And because of the expense, many people just went without insurance altogether. When those people had medical emergencies and ended up in a hospital, they couldn’t pay the resulting bills. When hospitals did not get paid by a significant minority of patients, they responded by raising the cost of care on everyone else to cover the losses they incurred from caring for patients that could not pay for those services. So everyone else paid higher prices for their medical care, which was passed on to consumers in the form of higher premiums charged by their insurance companies.What the ACA did was establish health insurance “exchanges” on which private companies would offer plans for people who did not receive insurance from their employers. The idea was that these companies would offer a variety of plans with different coverage options and different costs, all available to consumers in one place, and that by being forced to offer these plans side-by-side, insurers would have to offer more competitive pricing, and the various types of plans would be much easier for consumers to find. To aid low-income people in affording these plans, the federal government offered subsidies to cover a part of the cost of the monthly premium (in the same way that, for example, if you have insurance through your employer, the employer pays part of the monthly premium before deducting the rest from your paycheck.)But when you buy insurance on one of the exchanges, you are not enrolling in a government insurance program called “Obamacare”. You are buying insurance from a company like Aetna, or Fidelis, or United Healthcare. These are private companies that are in the business of making a profit. Their profit depends on taking in more money in premiums from healthy people than they are paying out in services to sick people.So when you hear “Obamacare premiums are rising,” what that means is that those private companies are now charging more for each plan they offer on the exchanges because they need to take more money in than they are paying out.So as far as why “Obama can’t make Obamacare free,” it’s because “Obamacare” doesn’t really exist, and he cannot directly influence what the private companies charge on the exchanges, and certainly cannot require them to charge nothing. Alternatively, covering the full cost of everyone on the exchanges through 100% subsidies would be extremely expensive; it would be more cost-efficient to simply create a government-run plan like Medicare that applied to everyone (Medicare only covers people over 65). But there’s not enough political support for a publicly funded government insurance plan like that, or at least there has not been up to now.So President Obama cannot directly affect what people pay for insurance on the ACA exchanges, and certainly cannot make those insurance plans free. But it’s important to note that most people do NOT buy insurance on these exchanges; somewhere between 80–85% of Americans get their insurance either through their employer or through Medicare or Medicaid. So increases in ACA premiums don’t affect most people, but the regulations established by the ACA, like the end to lifetime or annual coverage caps or the requirement that insurance companies must give young people up to age 26 the option to be covered on their parents’ plans, do apply to everyone, regardless of how you get your insurance.

There is still time but so far the Congressional Budget Office estimates seem pretty much on target. In June 2013, the CBO estimated that based on how the law was written, and the rules and regulations that ensued, that the uninsured in America would never fall below 30 million.It's shocking to consider because one of the main purposes of the ACA as proposed by Obama was to insure the uninsured.CBO: Uninsured Under Obamacare Never Falls Below 30 Million Surveys seem to show that most of the enrollees currently being counted are not Americans who were previously uninsured but rather are simply being switched from their current plan into one of the exchange plans.And the main problem isn't electronic. It's the product. 52% of those who haven't enrolled say that the cost of the plan offered on the exchange was too expensive. Only 30% said that it was due to technical difficulties with the site.As predicted, the "young invincibles" have done the math and decided it's much cheaper to pay the fine and then purchase insurance when needed given the absence of a pre-existing clause to prevent them from enrolling.Joan Budden, chief marketing officer at Priority Health, told Wilde and Mathews that Michigan’s health insurers had expected 400,000 uninsured Michiganders to enroll in exchange based plans during the initial enrollment year. According to the latest data from the Obama administration, as of December 28, only 75,511 had “selected a marketplace plan.” Of those, only an unknown fraction had paid their first month’s premium, and therefore were actually enrolled in new health coverage.“I don’t know if we’re growing the number of people with insurance,” a Minnesota-based health insurer told Wilde and Mathews. “We’re just adding complexity.”Coverage Expansion Fail: Less Than One-Third Of Obamacare Exchange Enrollees Were Previously Uninsured

There’s a significant subset of ACA policy holders that could lose coverage on January 20th, 2017. Here’s how - in 2 parts:Part 1:Most people are unaware of the federal subsidies called Cost Sharing Reductions (CSR) that the Obama administration has been paying to commercial insurance. These subsidies are what enable the insurance companies to offer Silver plans on the public exchange (Obamacare) at a “preferred/affordable” rate.These federal subsidies were being made - some claim illegally - from a fund that wasn’t appropriated by congress for this purpose - thereby overstepping the powers of the executive branch. In fact, there’s pending litigation by Congress against the administration for making these payments (House vs. Burwell). The Obama administration has been defending against this litigation (while continuing to make the payments) ever since the lawsuit was filed (July of 2014).Trump could simply stop defending against the litigation - AND - stop the payments. No legislation required.In fact, he could argue that the payments are, in fact, illegal (House vs. Burwell) and shift the burden to the democrats to challenge him in court. The point here is that the payments would effectively stop immediately until all legal actions were decided. As we’ve already seen with House vs. Burwell, that could easily take at least 2 years - and it could be all 4 years of his first term if it tracks to the Supreme Court (very possible).Part 2:Recognizing the huge political risk of these CSR payments, commercial insurance companies (like Aetna, Humana, UnitedHealth etc…) negotiated a deal that allows them to terminate those Silver plans tied to CSR’s immediately - once the government subsidies stop.Why would they do this? Because the Silver plans without the CSR subsidies are unprofitable - and they’ve already lost hundreds of millions of dollars on Obamacare. They have NO obligation to continue losing money - and, in fact, have both a legal and fiduciary responsibility to existing customers and shareholders to stop hemorrhaging money on Obamacare plans. As it is - many have opted out of the public exchanges already for this very reason even before the election.Stopping the CSR payments is another way to simply choke off the supply of affordable healthcare coverage under Obamacare. Again, no legislation or “repeal” needed.The question remains - will Trump do this? This is entirely unknown at this point - but it is well within his legal powers as President to do this - without even engaging congress. The point is - a key aspect of government subsidized health coverage - Silver Plans on the Health Insurance Marketplace (Obamacare) are already at significant risk for termination on (or about) January 20th, 2017.Other plans (in Bronze and Gold metal tiers) that don’t rely on CSR payments could remain intact - at least through the end of 2017 - as the “repeal and replace” plan unfolds. The likelihood of Obamacare being available during Open Enrollment (in fall of 2017 - for 2018 insurance coverage) is entirely unknown and at this point in time - it seems unlikely that we’ll know more until after Trump’s inauguration. Right now, Trump seems far more preoccupied with defending the Vice-President Elect on twitter from oral arguments by cast members at a Broadway play than the health or welfare of about 20 million Americans that are now enrolled in Obamacare.