The HealthCare.gov 2017 web site home page as seen in Washington, Monday, Oct. 24, 2016. The Obama administration is confirming that premiums will go up sharply next year for health insurance sold to... (Associated Press) 
 
 The HealthCare.gov 2017 web site home page as seen in Washington, Monday, Oct. 24, 2016. The Obama administration is confirming that premiums will go up sharply next year for health insurance sold to millions of consumers through HealthCare.gov. (AP Photo/Pablo Martinez Monsivais) (Associated Press) 
 
 The HealthCare.gov 2017 web site home page as seen in Washington, Monday, Oct. 24, 2016. The Obama administration is confirming that premiums will go up sharply next year for health insurance sold to millions of consumers through HealthCare.gov. (AP Photo/Pablo Martinez Monsivais) (Associated Press) The HealthCare.gov 2017 web site home page as seen in Washington, Monday, Oct. 24, 2016. The Obama administration is confirming that premiums will go up sharply next year for health insurance sold to... (Associated Press) 
 
 WASHINGTON (AP) — Premiums will go up sharply next year under President Barack Obama's health care law, and many consumers will be down to just one insurer, the administration confirmed Monday. That's sure to stoke another "Obamacare" controversy days before a presidential election. 
 
 Before taxpayer-provided subsidies, premiums for a midlevel benchmark plan will increase an average of 25 percent across the 39 states served by the federally run online market, according to a report from the Department of Health and Human Services. Some states will see much bigger jumps, others less. 
 
 Moreover, about 1 in 5 consumers will only have plans from a single insurer to pick from, after major national carriers such as UnitedHealth Group, Humana and Aetna scaled back their roles. 
 
 "Consumers will be faced this year with not only big premium increases but also with a declining number of insurers participating, and that will lead to a tumultuous open enrollment period," said Larry Levitt, who tracks the health care law for the nonpartisan Kaiser Family Foundation. 
 
 Republicans pounced on the numbers as a warning that insurance markets created by the 2010 health overhaul are teetering toward a "death spiral." Sign-up season starts Nov. 1, about a week before national elections in which the GOP remains committed to a full repeal. 
 
 "It's over for Obamacare," Republican presidential candidate Donald Trump said at a campaign rally Monday evening in Tampa, Florida. 
 
 Trump said his Democratic rival, Hillary Clinton, "wants to double down and make it more expensive and it's not gonna work. ... Our country can't afford it, you can't afford it." He promised his own plan would deliver "great health care at a fraction of the cost." 
 
 The new numbers aren't too surprising, said Sen. Orrin Hatch, R-Utah, who chairs a committee that oversees the law. It "does little to dispel the notion we are seeing the law implode at the expense of middle-class families." 
 
 HHS essentially confirmed state-by-state reports that have been coming in for months. Window shopping for plans and premiums is already available through HealthCare.gov. 
 
 Administration officials are stressing that subsidies provided under the law, which are designed to rise alongside premiums, will insulate most customers from sticker shock. They add that consumers who are willing to switch to cheaper plans will still be able to find bargains. 
 
 "Headline rates are generally rising faster than in previous years," acknowledged HHS spokesman Kevin Griffis. But he added that for most consumers, "headline rates are not what they pay." 
 
 The vast majority of the more than 10 million customers who purchase through HealthCare.gov and its state-run counterparts do receive generous financial assistance. "Enrollment is concentrated among very low-income individuals who receive significant government subsidies to reduce premiums and cost-sharing," said Caroline Pearson of the consulting firm Avalere Health 
 
 But an estimated 5 million to 7 million people are either not eligible for the income-based assistance, or they buy individual policies outside of the health law's markets, where the subsidies are not available. The administration is urging the latter group to check out HealthCare.gov. The spike in premiums generally does not affect the employer-provided plans that cover most workers and their families. 
 
 In some states, the premium increases are striking. In Arizona, unsubsidized premiums for a hypothetical 27-year-old buying a benchmark "second-lowest cost silver plan" will jump by 116 percent, from $196 to $422, according to the administration report. 
 
 But HHS said if that hypothetical consumer has a fairly modest income, making $25,000 a year, the subsidies would cover $280 of the new premium, and the consumer would pay $142. Caveat: if the consumer is making $30,000 or $40,000 his or her subsidy would be significantly lower. 
 
 Dwindling choice is another issue. 
 
 The total number of HealthCare.gov insurers will drop from 232 this year to 167 in 2017, a loss of 28 percent. (Insurers are counted multiple times if they offer coverage in more than one state. So Aetna, for example, would count once in each state that it participated in.) 
 
 Switching insurers may not be simple for patients with chronic conditions. 
 
 While many carriers are offering a choice of plan designs, most use a single prescription formulary and physician network across all their products, explained Pearson. "So, enrollees may need to change doctors or drugs when they switch insurers," she said. 
 
 Overall, it's shaping up to be the most difficult sign-up season since HealthCare.gov launched in 2013 and the computer system froze up. 
 
 Enrollment has been lower than initially projected, and insurers say patients turned out to be sicker than expected. Moreover, a complex internal system to help stabilize premiums has not worked as hoped for. 
 
 Nonetheless, Obama says the underlying structure of the law is sound, and current problems are only "growing pains." The president has called for a government-sponsored "public option" insurance plan to compete with private companies. 
 
 Republicans, including Trump, are united in calling for complete repeal, but they have not spelled out how they would address the problems of the uninsured. 
 
 Clinton has proposed an array of fixes, including sweetening the law's subsidies and allowing more people to qualify for financial assistance. 
 
 The law makes carrying health insurance a legal obligation for most people, and prohibits insurers for turning away the sick. It offers subsidized private plans to people who don't have coverage through their jobs, along with a state option to expand Medicaid for low-income people. 
 
 Largely as a result, the nation's uninsured rate has dropped below 9 percent, a historically low level. More than 21 million people have gained coverage since the Affordable Care Act passed in 2010. 
 
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 https://aspe.hhs.gov/pdf-report/health-plan-choice-and-premiums-2017-health-insurance-marketplace ||||| The decision to end the payments, worth an estimated $7 billion this year, marks President Donald Trump's most aggressive move yet to dismantle Obamacare. | Brendan Smialowski/AFP/Getty Images Trump will scrap critical Obamacare subsidies Cutting off the payments to insurers, which could happen almost immediately, is likely to provide another jolt to Obamacare markets. 
 
 President Donald Trump plans to cut off subsidy payments to insurers selling Obamacare coverage in his most aggressive move yet to undermine his predecessor's health care law. 
 
 The subsidies, which are worth an estimated $7 billion this year and are paid out in monthly installments, may stop almost immediately, since Congress hasn’t appropriated funding for the program. 
 
 Story Continued Below 
 
 The decision — which leaked out only hours after Trump signed an executive order calling for new regulations to encourage cheap, loosely regulated health plans — delivered a double whammy to Obamacare after months of failed GOP efforts to repeal the law. With open enrollment for the 2018 plan year set to launch in two weeks, the moves seem aimed at dismantling the law through executive actions. 
 
 Press secretary Sarah Huckabee Sanders confirmed the decision in a statement emailed to reporters Thursday night. 
 
 “Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare,” she said. “In light of this analysis, the Government cannot lawfully make the cost-sharing reduction payments. … The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system.” 
 
 Trump's move to scrap the subsidy payments, which was first reported by POLITICO, is likely to jolt already fragile Obamacare markets — although the impact might be less severe than it would have been a few months back. 
 
 “Certainly problematic markets are going to become more unstable," said Greg Scott, who oversees Deloitte’s health plans consulting practice. 
 
 Adding to the uncertainty, Trump on Friday morning appeared to express hope that his decision to cut off the subsidies would help him cut a legislative deal, possibly with Democrats. "The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!" Trump tweeted. 
 
 The president has made overtures in the past to Democrats on health care, tweeting last Saturday that he had talked with Senate Minority Leader Chuck Schumer about potential negotiations. But Schumer separately said Trump had suggested another Obamacare repeal-and-replace effort, which the New York Democrat said was a nonstarter. 
 
 On Thursday night, Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) issued a joint statement calling Trump's latest move "sabotage." 
 
 “It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America," they said in a joint statement. "Make no mistake about it, Trump will try to blame the Affordable Care Act, but this will fall on his back and he will pay the price for it." 
 
 But many insurers had priced next year's plans higher than they otherwise would have, fearing this outcome after months of threats from the White House. Others have already fled the Obamacare markets, which are set to begin open enrollment in Nov. 1 for the 2018 plan year. 
 
 “What it adds up to me is a gross dereliction of duty,” John Baackes, CEO of L.A. Care Health plan, said of the decision. “The Affordable Care Act is still the law of the land and the cost-reduction subsidies are part of that. … Even if there’s a lawsuit about it, it should still be honored until the last appeal is exhausted. I thought they took oaths to uphold the law of the land. They’re just flaunting it now.” 
 
 Trump has threatened for months to cut off the payments, deriding them as a “bailout” for insurers. California, the country’s most successful Obamacare marketplace, added a 12.5 percent surcharge this week on silver plans as a hedge against the possibility the subsidies would be pulled. By loading them on silver plans, taxpayers will pick up the cost. 
 
 While Republican lawmakers complained the subsidies were never properly appropriated by Congress, many were wary of ending them suddenly. 
 
 Failed Obamacare repeal packages considered by the House and Senate included near-term funding for the program, which had been paid out through the executive branch each month. 
 
 Attorney General Jeff Sessions said Friday on Fox News that the subsidies were not on solid legal ground to begin with because Congress did not appropriate them. He said it's up to Congress to step in. 
 
 "It's time for Congress to fix this bill. That's what needs to happen. Congress has got to get together," Sessions said. "Republicans and the Democrats, they've got to come on board and they've got to develop a plan that will actually work. It can not continue in this fashion. It's in a death spiral it seems to me." 
 
 In the near term, the announcement is expected to put more pressure on a bipartisan effort in the Senate's health committee to preserve the subsidies to shore up Obamacare marketplaces. 
 
 “While I’m sure initial reactions will be negative, this might be the spark Congress needs to act on this issue," said an insurance lobbyist who declined to be named. "There was no pressure before … That might actually be the silver lining.” 
 
 As the White House reached out to lawmakers to inform them of its decision Thursday night, even some Republican lawmakers expressed consternation. 
 
 "Cutting health care subsidies will mean more uninsured in my district," tweeted Rep. Ileana Ros-Lehtinen, a Florida Republican late Thursday. "@potus promised more access, affordable coverage. This does opposite." 
 
 New York Attorney General Eric Schneiderman, who led a group of Democratic attorneys general to defend the subsidies in court this past spring, said they would sue to stop the administration from acting. 
 
 "I will not allow President Trump to once again use New York families as political pawns in his dangerous, partisan campaign to eviscerate the Affordable Care Act at any cost," he said in a prepared statement. 
 
 Some insurers are also likely to sue the Trump administration over the failure to make payments that they believe they’re entitled to under the Affordable Care Act. 
 
 Insurers will have the option to try to adjust their rates or pull out of the markets immediately when the subsidy payments end. That's because the contracts insurance companies signed to offer Obamacare plans have an "out" if the payments stop. 
 
 But it’s far from certain whether insurers would try to leave markets. They would have to go through an extensive back-and-forth with state regulators on changes, a process that could be lengthy and could vary by state. 
 
 Trump has argued that Democrats will take the blame if the markets implode, but polling strongly suggests the public will point the finger at Republicans for Obamacare problems under Trump's watch. 
 
 Dan Diamond, Jennifer Haberkorn, Renuka Rayasam and Victoria Colliver contributed to this report.
– Premiums will go up sharply next year under President Obama's health care law, and many consumers will be down to just one insurer, the administration confirmed Monday. That's sure to stoke another ObamaCare controversy days before a presidential election, the AP reports. Before taxpayer-provided subsidies, premiums for a midlevel benchmark plan will increase an average of 25% across the 39 states served by the federally run online market, according to a report from the Department of Health and Human Services. Some states will see much bigger jumps, others less. Major national carriers such as UnitedHealth Group, Humana, and Aetna scaled back their roles, meaning about one in five consumers will only have plans from a single insurer to pick from. Republicans pounced on the numbers as a warning that insurance markets created by the 2010 health overhaul are teetering toward a "death spiral." "It's over for ObamaCare," Donald Trump proclaimed at a campaign rally Monday evening in Tampa, Fla., promising that his own plan would deliver "great health care at a fraction of the cost." Administration officials, however, stress that subsidies provided under the law, which are designed to rise alongside premiums, will protect most customers.