"This has been the most unstable and challenged health insurance market in my tenure as a public servant. The degree of uncertainty and instability that the Trump administration has injected into the market this year cannot be understated." 

—Dave Jones, California's Health Insurance Commissioner

• Trump Administration Rolls Back Birth Control Mandate New York Times by Robert Pear, Rebecca R. Ruiz, and Laurie Goodstein — The Trump administration on Friday moved to expand the rights of employers to deny women insurance coverage for contraception and issued sweeping guidance on religious freedom that critics said could also erode civil rights protections for lesbian, gay, bisexual and transgender people. The twin actions, by the Department of Health and Human Services and the Justice Department, were meant to carry out a promise issued by President Trump five months ago, when he declared in the Rose Garden that "we will not allow people of faith to be targeted, bullied or silenced anymore." Attorney General Jeff Sessions quoted those words in issuing guidance to federal agencies and prosecutors, instructing them to take the position in court that workers, employers and organizations may claim broad exemptions from nondiscrimination laws on the basis of religious objections.
  
  
• California Suing Trump Administration Over Rollback of Birth Control Rule Huffington Post by Mollie Reilly —  California Attorney General Xavier Becerra announced Friday he has filed a lawsuit challenging President Donald Trump’s decision to end insurance coverage requirements for birth control. Becerra’s suit comes hours after Trump’s administration announced a new rule that will allow all employers to opt out of including birth control in their health care plans, rolling back an Obama-era mandate that guaranteed 62 million women access to contraception at no cost. The American Civil Liberties Union filed a similar suit Friday, also arguing the rules violate the Establishment and Equal Protection clauses.
  
  
• How Trump Is Planning to Gut Obamacare by Executive Order Vox by Dylan Scott — With a repeal bill off the table, the Trump administration has drafted an executive order that could blow a huge hole in the Affordable Care Act, according to a source with direct knowledge of the plan. The order would, in effect, exempt many association health plans, groups of small businesses that pool together to buy health insurance, from core Obamacare requirements like the coverage of certain essential health benefits. It would potentially allow individuals to join these plans too, which would put individual insurance marketplaces in serious peril by drawing younger and healthier people away from them. The draft order is also said to broaden the definition of short-term insurance, which is also exempt from the law’s regulations.
  
  
• Even Red States Feel Left in the Lurch by the Trump Administration's Management of Health Care Los Angeles Times by Noam Levey — As it works to roll back the Affordable Care Act, the Trump administration is letting crucial state health initiatives languish, frustrating a growing number of state leaders, including several from solidly Republican states. Last week, Oklahoma's health secretary sent a blistering letter to senior administration officials, taking them to task for failing to approve a plan state officials drew up to protect their consumers from large rate hikes. Health officials in other states say the federal health agency for months provided little help as they tried to plan for the expiration of federal funding for the popular Children's Health Insurance Program, or CHIP. Money for the program, which covers nearly 9 million children, has begun to lapse because Congress failed to hit a deadline of Sept. 30 to renew the program, something lawmakers still hope to accomplish this year.

• Health Care Premiums for 2018 Set to Go Up by as Much as 50 Percent Marketplace by Dan Gorenstein and Jana Kasperkevic — Several states have announced rates for health insurance premiums on the Obamacare exchanges for 2018. Topping the list is Georgia, with rates that are 57 percent higher than last year, while Florida said some premiums will be 45 percent higher. Among the reasons for these increases is the uncertainty about the future of the Affordable Care Act. President Donald Trump has vowed to repeal and replace the health care law, which was passed under his predecessor President Barack Obama. Congress had repeatedly tried and failed to deliver on President Trump's promise. Insurers are raising premiums in the face of repeated threats from President Trump to stop funding so-called cost-sharing reductions, payments to insurers that cover out-of-pocket costs for some low-income consumers. Trump previously referred to these payments as "bailouts" for insurance companies and threatened to stop making the payments so as to "let Obamacare implode."
  
  
• Obamacare Sign-Up Challenge: Proving the Law is Not Dead Reuters by Yasmeen Abutaleb — More than two thousand miles away from the health care debate in Washington, President Donald Trump's threats to let Obamacare collapse are sowing confusion about its fate and dampening 2018 enrollment expectations. The uncertainty here in Arizona, echoed in interviews across the country, shows that even though they have not been able to repeal former President Barack Obama's signature health care law, the Republican effort to undermine it is gaining traction.…Knowing Republicans have vowed to keep trying until they succeed, consumers are increasingly hesitant to sign up, according to Reuters interviews with half a dozen enrollment groups, as well as industry experts and people looking to get insurance next year.
  
  

• Cassidy Eyes Changes to Health Care Bill While Trying to Win Support Roll Call by Mary Ellen McIntire — Louisiana Sen. Bill Cassidy said there will be changes to a proposal he wrote to overhaul the 2010 health law as he and fellow Republican Sen. Lindsey Graham of South Carolina try to win more support for the measure while other lawmakers focus on tax legislation. …Cassidy said he and other sponsors need to promote the plan in the coming months so people can learn about the changes the bill would make and better understand it. He said that time could also be used to address concerns of lawmakers such as Arizona GOP Sen. John McCain, who had concerns with the abbreviated process. Neither the Senate Finance Committee nor the Health Education, Labor, and Pensions Committee has indicated they have plans to hold more hearings on the bill. The Finance Committee had a hearing on the legislation before it was pulled last week.

• GOP Gives Ground in Obamacare Stabilization Talks The Hill by Nathaniel Weixel — Republicans are willing to provide insurers with two years of Obamacare subsidies under a bipartisan market stabilization bill, according to the Senate Health Committee chairman. Sen. Lamar Alexander (R-Tenn.) said continuing cost-sharing reduction subsidies for two years is a key part of the stabilization package he is trying to negotiate with Sen. Patty Murray (D-Wash.). Alexander and Murray are continuing to try to rally Republicans and Democrats around a short-term plan to lower Obamacare premiums in 2018 and 2019.

• House Passes GOP Budget in Key Step for Upcoming Tax Debate Associated Press by Andrew Taylor — The House on Thursday passed a $4.1 trillion budget plan that promises deep cuts to social programs while paving the way for Republicans to rewrite the tax code later this year. The 2018 House GOP budget reprises a controversial plan to turn Medicare into a voucher-like program for future retirees as well as the party's efforts to repeal the "Obamacare" health law….The House measure, passed by a near party-line vote of 219-206, calls for more than $5 trillion in spending cuts over the coming decade, promising to slash Medicaid by about $1 trillion over the next 10 years, cutting other health care costs, and forcing huge cuts to domestic programs funded in future years by Congress.

Editor: Peter Van Vranken