washington trump administration make cost-sharing payments insurance company obamacare august white house spokesman say wednesday announcement little quell long-term concern insurance market president donald trump republican repeatedly threaten stop payments make directly insurance company help cover out-of-pocket medical expense low-income americans enrol individual healthcare plan affordable care act aca payments estimate amount billion 2017. center medicare medicaid service also say wednesday two counties project insurer 2018 sell plan individual market create former democratic president barack obama healthcare policy 40 early year announcements could bring short-term stability insurance market long-term outlook uncertain say cynthia cox policy researcher associate director nonprofit kaiser family foundation past several months trump republicans lawmakers control chamber congress regularly point number expect so-called bare counties 2018 argue bill repeal replace obamacare insurers still unsure whether republicans try repeal replace law return september recess whether trump administration permanently make insurer payments also know whether administration enforce requirement aca americans buy health insurance else pay fine unclear whether federal government play role provide incentives insurers offer plan bare counties many risk anthem inc one large remain obamacare insurers par back offer several state say cox state officials insurance commissioners work provide incentives centene corp fill many gap health plan work hard insurance commissioners state leaders ensure americans buy coverage options affordable possible say kristine grow spokeswoman insurer lobby group america health insurance plan demonstration commitment nonpartisan congressional budget office tuesday estimate health insurance premiums many customers obamacare individual insurance market would 20 percent high 2018 trump stop insurer payments trump make august cost-sharing payments health insurers