More like going belly-up in most cases.

You remember Dr. Ezekiel Emanuel, don’t you? He’s the brother of Rahm, who played an instrumental role in crafting and promoting Obamacare — and who occasionally lets the truth slip regarding its myriad broken promises. Here he is admitting what has become painfully obvious: The so-called ‘Affordable’ Care Act that he helped design, and that Democrats marketed to the public as a cost-reduction measure, is failing by its own standards. “We need to focus on cost control,” means “the law isn’t controlling costs.” The doctor is correct on this point:

With the open enrollment deadline for Obamacare looming next month, one of the chief architects of the president’s health law said Friday the plans offered on government-run exchanges need to be more affordable in order to boost participation rates. High-deductible plans are part of the problem, Dr. Ezekiel Emanuel added…”Even though I am a liberal, I think we really have to focus on cost control. Affordability is absolutely critical across the board, because if we don’t have affordable plans we are not going to get universal coverage. They are intimately linked,” said Emanuel…He did acknowledge: “We’ve overplayed the high-deductible plans. People are feeling this is less and less insurance. And just more and more, ‘I’m paying out of my pocket.'”

With rates rising substantially across most of the country, consumers are also being pummeled with climbing out-of-pocket costs. They’re forking over a fortune before the coverage they’re paying into each month even kicks in at all — and when it finally does, many are discovering narrow networks and difficulty securing actual care. It’s telling that Obamacare godmother and cheerleader Hillary Clinton feels compelled to offer new healthcare affordability proposals. Democrats can repeat the empty “it’s working” slogan all day long; their presumptive nominee’s actions tell the real story. Last week, America’s largest private insurer signaled that it is seriously considering pulling out of the Obamacare market, citing major losses that could prove unsustainable over time. This is a big deal, and Philip Klein has been all over it:

UnitedHealth Group, the largest insurance company in the U.S., on Thursday slashed its earnings outlook, citing new problems related to Obamacare, and told investors it may exit the program’s exchanges. “In recent weeks, growth expectations for individual exchange participation have tempered industrywide, co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated,” Stephen J. Hemsley, chief executive officer of UnitedHealth Group, said in a press release. The release added that, “UnitedHealthcare has pulled back on its marketing efforts for individual exchange products in 2016. The company is evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.”

In that single compact quote, Hemsley makes several key points. He notes that new enrollment projections have been slashed, that a slew of state-level Obamacare co-ops have gone belly up, and that the adverse selection problem arising from older, sicker risk pools is real.