How big an issue will Obamacare be in the November election?

The bad news is beginning to roll in for health insurance consumers as companies request rate increases in states across the country.

Most of those rates will be set by October 1 - the official date for the start of Obamacare open enrollment. But even looking a rate increaes in 2015 could give indigestion to Hillary Clinton  and her supporters.

Linda J. Blumberg, John Holahan, and Erik Wengle at the Robert Woods Johnson Foundation and Urban Institute made a careful study of premium increases in all 50 states in 2015. They found that trying to gauge increases in the aggregate was useless because of different market conditions. Instead, they concluded the focus should be on "understanding the wide variability by identifying the characteristics of markets that have experienced high premiums or high growth in premiums and of markets with lower premiums or lower growth in premiums."

AoL News:

Only five states saw a decrease in premium cost this year, while 12 states had increases of more than 20%, on average. The heavily impacted states are predominately in the Midwest, but almost every region got hit with price jumps.

The variance is startling. The largest increase came from Alaska, which saw premium prices surge 40.2% this year, while on the other end, Indiana's prices decreased by 12.1%.

In all, about 48% of the population lives in areas where prices decreased or increased by less than 5%. 26.3% of the US population lives in areas that had an increase of more than 15%.

The researchers found that there are a variety of reasons for the discrepancy in prices, but the biggest difference-maker was competition.

"However, the most important factors associated with lowest-cost silver plan premiums and premium increases are those defining the contours of competition in the market," the report concluded. "Rating areas with more competitors had significantly lower premiums and lower rates of increase than those that did not."

The paper also found that there was one player that had more of an effect on prices than any other provider.

"Those rating areas with a Medicaid insurer competing in the marketplace also have lower premiums and lower rates of increase than those regions without a Medicaid insurer competing," said Blumberg, Holahan, and Wengle.

This is an issue as insurance companies evaluate the profitability of the state exchanges. With political pushback against expanding Medicaid considerable, private insurers are going to have to carry most of the load and provide competitions.

This is significant because if more competition is likely to keep rate increases in check, consumers are in big trouble this year. Several of the largest insurance companies have dropped off the state exchanges as have smaller companies.

The result is that some state exchanges only have one or two companies servicing the entire state.

The political fallout will depend on how well Republicans can articulate the concern of voters over highter premiums and deductibles and once again, tie Obamacare to the Democrats.

The Hill:

Kaiser Family Foundation poll in January found that 44 percent of the public had an unfavorable view of the law, while 41 percent had a favorable view. That is an improved picture for Democrats from 2010 or even 2014. 

More recently, though, the unfavorables have ticked back up due to Democrats unhappy the law does not go further, the Kaiser Family Foundation found.

Bannon also noted that more of the public wants to improve the law, rather than completely repeal it, as Republicans call for. 

The Kaiser poll found that 30 percent want to expand the law, 14 percent want to keep it as is, 11 percent want to scale it back, and 32 percent want to repeal it completely.  

Clinton is with those trying to improve the law, which could give her cover with voters.

Many of her solutions tack to the left. Most prominently, she supports the “public option,” a government-run health insurance alternative to increase competition. 

She said it could take the form of allowing people to buy into Medicare once they reach age 50 or 55 at a roundtable this month. Because the eligible people tend to have higher health costs, shifting them out of the private market and into Medicare could lower costs for everyone else, she noted. 

Clinton has also proposed measures including a new tax credit to help people with out of pocket costs and “vigorously” enforcing antitrust laws to crack down on health insurance company mergers that would reduce competition. 

But the size of premium increases could still spell trouble.

ObamaCare premiums are expected to rise more this year in part because insurers initially set their premiums too low. The pool of enrollees has been smaller and sicker than expected and many insurers now need to raise premiums to stop losing money.

An analysis from the consulting firm Avalere Health last week found that early data from nine states indicate an average 16 percent premium increase, compared to about 6 percent at this point last year. 

There are examples of even bigger increases. Providence Health Plan, one of Oregon’s largest insurers, is seeking a 29.6 percent increase.

Unless there is an infusion of younger, healthier customers in  the Obamacare pool of consumers, these increases will become unsustainable. And there is zero evidence so far that Obamacare is attracting millennials in massive numbers.

Of course, much will depend on where these spikes in premiums occur. The more competitive the state in the fall election, the more impact Obamacare premiums will have on the race. 

It won't be a deciding factor. But the rise in premiums will contribute to a general unease people might feel voting Democratic.