Officials roll out 'Obamacare' fixes as repeal remains goal

Insurers and major medical groups have warned that not funding the payments could wreak havoc in individual insurance markets, and penned a letter to Trump the same day urging him to maintain funding to the subsidies.

Trump has predicted that Democrats will own ObamaCare if it falls apart, which he said would happen after legislation repealing the law was pulled from a House vote because of opposition from Republicans.

Critics say the Trump administration's policies and actions have also helped destabilize the markets. Republicans sought to delay the court case after Trump was elected president.

Mr Trump vowed to repeal and replace the Affordable Care Act, former President Barack Obama's signature healthcare law, during the presidential election.

Thursday's fixes include a shorter enrollment window and curbs on "special enrollments" after insurers complained that some people were gaming the system.

But the White House remained mum on the biggest concern.

Nancy Pelosi was a bit harsher: "Refusing to make the Cost Sharing Reduction payments has no goal but to hurt millions of people, and manufacture a crisis". They're separate from the better-known premium subsidies that most customers receive. "And that would dramatically disrupt the insurance markets, and we should not let that happen". For example, bronze plans, which now must cover no less than 60 percent of medical costs, will be allowed next year to cover 56 percent to 62 percent.

The unusual ploy has caused concern among insurers, hospitals and other groups, who say individual premiums could rise almost 20 percent and insurers might exit the marketplace if they don't get the money.

The Trump team says it's making this subsidy cutoff threat in order to get the Democrats to come to the bargaining table on the new health-care bill. But the president also said he hasn't made up his mind, and said he doesn't want people to get hurt.

Aides to top Democratic leaders say the issue is now at the top of their list of demands. "No decision has been made about how the administration will proceed".

— A shortened sign-up window of 45 days, starting with coverage for 2018.

The flashpoint this time is a key funding stream for the program ― one that subsidizes insurers so they can offer low-income consumers plans with reduced out-of-pocket expenses.

Without an ironclad guarantee that the subsidies would keep flowing, industry representatives said, insurers would be forced to raise premiums for the 2018 plan year to account for the uncertainty.

Doing so would likely mean raising premiums for the typical plan by 19 percent, according to an analysis by the Henry J. Kaiser Family Foundation.

While competition and choice are lacking in some markets across the country, on average marketplace consumers have 30 plans to choose from, the federal government reports.

Most communities will have competing insurers on the public marketplace next year, but a growing number will be down to one, and some areas may face having none.

In Iowa, two of the state's four insurers announced they would not participate in 2018 - Wellmark Blue Cross and Blue Shield and Aetna.

But he failed to do so during his first months in officer after a bill to overhaul the system was rejected by the Republican-controlled Congress due to a lack of support.

Meanwhile, the legal issue over the cost-sharing subsidies also remains in limbo.

A federal District Court judge agreed with the Republicans' argument and ordered a halt to the payments, but she suspended her order to allow the government to appeal. They say the Affordable Care Act required Congress to approve that spending, and they hadn't.

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