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. 
 
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 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. ||||| Sen. Lamar Alexander tweeted that he would work with President Donald Trump on improving the bill to "make it even stronger" and ensure that it benefits consumers, not insurance companies. | John Shinkle/POLITICO Obamacare fix could end up in year-end package Republican sources say it's only a matter of time before Congress must find some way of addressing the reeling insurance markets. 
 
 A bipartisan deal to shore up Obamacare collapsed Wednesday after President Donald Trump and House Speaker Paul Ryan called the Senate proposal a bailout for insurance companies. 
 
 But GOP sources on both sides of the Capitol say this is not the end of the debate. 
 
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 GOP lawmakers acknowledged they’ll eventually have to contend with shaky insurance markets and an estimated $1 billion hole Trump carved into the health care law last week when he eliminated remaining payments due this year. The money to fund a key insurance subsidy program could be resurrected as part of a year-end spending agreement. 
 
 Even if the deal struck by Sens. Lamar Alexander and Patty Murray goes nowhere, Republican sources say it's only a matter of time before Congress must find some way of addressing the reeling insurance markets — a vote the GOP sources know will infuriate lawmakers and their base. Put simply, the fight over Obamacare is nowhere near an end. 
 
 Alexander plans to introduce the bill Thursday along with a “significant” number of Republican and Democratic cosponsors. He predicted Wednesday that “by the end of the year chances are very good this agreement or something like it is law.” 
 
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 The most likely scenario is to push the matter off and fold a yet-to-be-determined solution into a year-end package they hope will include some GOP concessions as well as Democratic perks. Such a strategy, they argue, would be less painful than voting on a stand-alone bill that conservatives view as a "bailout" for insurance companies — and a vote to "prop up" a law they've tried to dismantle for years. 
 
 "We do know there's a problem with the high premiums and high deductibles because of the failures of Obamacare,” said Sen. John Cornyn (R-Texas). "And until we can come up with a long-term solution, I think stabilizing the marketplace and keeping premiums affordable is not a bad idea.” 
 
 Earlier in the day, Trump tweeted that he was "supportive of Lamar as a person & also of the process, but I can never support bailing out ins co’s who have made a fortune w/ O’care." 
 
 Ryan later suggested the House wouldn't take up the bill as written. 
 
 "The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare," Ryan spokesman Doug Andres said. 
 
 Alexander on Wednesday lobbied his GOP colleagues to get on board, arguing that funding the cost-sharing program doesn't amount to a bailout because it has to go directly to cover consumers’ out-of-pocket health costs. He also indicated that he’s open to changing the bill to address Trump’s concerns. 
 
 Ron Johnson (R-Wis.) is also working on a bill that would fund the cost-sharing payments and make concessions for conservatives. 
 
 The Alexander-Murray deal would provide two years of funding for Obamacare's cost-sharing subsidies. It would also give states more flexibility to oversee their insurance markets, expand the availability of low-cost health plans and restore some of the funding for enrollment outreach efforts the Trump administration slashed this summer. 
 
 But Alexander’s effort largely fell on deaf ears. 
 
 “I want to get to the long-term solution as quickly as possible. I’m just not a fan of bailing out insurance companies,” said Steve Daines (R-Mont.). 
 
 Trump’s opposition sealed the bill’s fate, at least in the short term. It would be all but impossible for Republicans lawmakers to support the deal — let alone bring it up for a vote in the House or Senate — without the president's endorsement. Republicans, still smarting from their failure to fulfill their years-long promise to repeal Obamacare, would have an extremely hard time voting for anything perceived as supporting the law without political cover from the president. 
 
 Before coming out against the proposal Wednesday, Trump spent Tuesday sending mixed signals on whether he would support the bipartisan effort. Early Tuesday, he suggested the White House was involved in crafting the legislation and praised the work by lawmakers. By the evening, he commended the work but trashed the idea of a bailout, echoing comments made by conservatives who oppose the deal. 
 
 Republicans were reluctant to weigh in on the deal after details of the bill were released Tuesday. But GOP sources, especially in the House, privately began dismissing the accord, saying the concessions wouldn’t be enough for most Republicans in the House. 
 
 Asked about a vote on the agreement Tuesday, Majority Leader Mitch McConnell said Republicans had not yet discussed a way forward. Ryan soon came out in a statement encouraging the Senate to pursue repeal — not an Obamacare "fix." 
 
 Some Republicans want a bigger concession from Democrats in exchange for continuing the payments. In an interview with POLITICO just hours after Trump ended the subsidies last week, Office of Management and Budget Director Mick Mulvaney said the White House would never back a stand-alone Alexander-Murray-type deal but could accept the measure if they got a border wall or something else for Trump. 
 
 White House legislative liaison Marc Short and GOP sources echoed that sentiment, suggesting that Republicans might instead secure a repeal of the individual and employer mandates under Obamacare. 
 
 Democrats are highly unlikely to back any kind of mandate repeal because they would view that as undermining the law. Murray told POLITICO that she views the bill's current language as final. "We negotiated," she said. 
 
 The Obamacare payments are estimated at about $7 billion this year and help insurers cover out-of-pocket costs for low-income customers. Insurance commissioners say about $6 billion of the money had been released before Trump's cutoff. A federal court last year ruled that the subsidies were illegally appropriated, but the Obama and Trump administrations had continued to pay them out while the litigation is under appeal. Many insurers, fearing the payments would be cut off, raised rates for 2018 health plans higher than they otherwise would have. 
 
 Minority Leader Chuck Schumer on Wednesday blasted Trump for flip-flopping. He said Trump probably did not know what was in the Obamacare deal and said his only hope was that Trump would quickly reverse course to support it. 
 
 Adam Cancryn contributed to this report. ||||| President Trump became the subject of an unusual public lobbying campaign over the fate of the Affordable Care Act on Wednesday as Senate Democrats and a key Republican sought to salvage a bipartisan health deal while conservatives pressured the president to disavow the agreement. 
 
 In a morning tweet, Trump appeared to distance himself from the compromise, which would authorize payments to insurers that help offset millions of lower-income Americans' health costs in exchange for granting states greater flexibility to regulate coverage. But the president later told reporters that he was not closing the door on a deal altogether, and proponents of the plan authored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) sought to keep him on board. 
 
 The convoluted campaign, in which Senate Minority Leader Charles E. Schumer (D-N.Y.) insisted that a deal remained in reach even as he blasted the president's "zigging and zagging," underscored the unpredictable nature of dealmaking in Trump's Washington. With constantly shifting alliances, the city's key political players are jockeying to win the president's support one issue at a time. 
 
 For Senate Democrats, trying to sway Trump to back the plan carries both potential risks and rewards. Working with a president despised by their base and prone to changing his mind could drag them into a political quagmire with unpredictable outcomes. 
 
 For conservatives who are pressing for a different deal or oppose the idea of propping up the Affordable Care Act, the moment presents a test of how much influence they have with the president, who has suggested a greater willingness to hash out deals with Democrats and become more and more frustrated with his own party. 
 
 [Another last-ditch effort to tackle Obamacare stalls within hours of its release] 
 
 For both sides, the president's conflicting signals have created a chaotic situation where even some of Trump's aides have found themselves scrambling to keep up with the latest developments. 
 
 He began the morning by warning that the new agreement might be tantamount to an insurance giveaway. "I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co's who have made a fortune w/ O'Care," Trump wrote on Twitter. 
 
 But shortly afterward, Alexander — who chairs the Health, Education, Labor and Pensions Committee and was encouraged by the president to pursue a deal — said in an interview that Trump expressed an openness to preserving it in a phone call Wednesday morning. 
 
 "He told me that he wanted to encourage me but that he will review it, as I would expect a president to do," Alexander said. "He may want to add something to it. It may come up as part of the end-of-the-year negotiations. We'll see." 
 
 Speaking later to reporters in the Cabinet Room, Trump praised Alexander's efforts, saying, "If something can happen, that's fine, but I won't do anything to enrich the insurance companies. 
 
 
 
 Sens. Patty Murray (D-Wash.) and Lamar Alexander (R-Tenn.) attend a hearing on Capitol Hill on Wednesday, the morning after they reached a deal to resume federal payments to health insurers that President Trump had halted. (J. Scott Applewhite/AP) 
 
 "They've been enriched by Obamacare like nothing anybody's ever seen before," the president added. 
 
 Although Trump has repeatedly described cost-sharing payments as a "bailout" to insurers, the money directly covers the discounts that low-income Americans on Affordable Care Act plans receive for deductibles and other out-of-pocket costs. This group includes about 7 million Americans earning up to 250 percent of the federal poverty level. 
 
 Insurers are obligated to provide the discounts, which totaled about $7 billion this year and are estimated to reach $10 billion next year, even if the federal payments are cut off. According to the National Association of Insurance Commissioners, Trump's decision last week to end the subsidies will cost insurance carriers more than $1 billion this year. 
 
 Facing the prospect for months that the Trump administration would cut off the payments, most insurers have opted to factor this shortfall into their 2018 premium rates for their customers. The cutoff in cost-sharing payments has translated into premium increases of 12 percent to 20 percent, according to several analyses. 
 
 Alexander suggested that he may tweak the language of the proposal to address Trump's concerns that insurers would benefit from the cost-sharing reduction payments. He added that during their Wednesday call, he told Trump that he was about to tell reporters, "They're underestimating your leadership on health care, because what you've done is you've created a bipartisan option for the Senate and for the country." 
 
 Alexander said that the compromise already has language to ensure that the subsidy "benefits go to consumers, not to insurance companies," but he was open to making it stronger. 
 
 Schumer, for his part, alternated between attacking Trump's inconsistent policy positions and arguing for why the president and the deal's proponents agreed on a short-term health-care fix. 
 
 Trump ended the cost-sharing reduction payments, known as CSRs, last week, arguing that they were illegal because they were not explicitly authorized under the Affordable Care Act. He left it to Congress to decide whether to fund them. 
 
 [Senators strike deal to save Obamacare payments as insurers push to raise rates] 
 
 Schumer, who discussed the prospect of a bipartisan deal with Trump less than two weeks ago when the president called him in the Senate gym, said in a floor speech that the allegations of an insurance bailout show that "the president doesn't know what he's talking about." 
 
 "It helps people who are sick and need health care. It keeps their premiums low," Schumer said of the funding, adding that there is language in the agreement that bars insurers from pocketing the money. 
 
 During the negotiations, Democrats had proposed delaying the open enrollment period for Affordable Care Act plans, which is set to begin Nov. 1, for a month after the bill's enactment to ensure that firms could lower their 2018 premium rates to reflect the fact that the government would keep funding the subsidies. White House Domestic Policy Council Director Andrew Bremberg opposed that provision, Schumer said, but he added that Democrats are willing to insert stronger language to guarantee that insurers pass on the payments to their customers. 
 
 "We're all of the same mind," Schumer said of Trump, Senate Democrats and Alexander. "And we can do that." 
 
 In a brief interview Wednesday afternoon, Murray brushed aside the president's hostile rhetoric. 
 
 "This is not about the president. This is about just doing the right thing so the American people's rates don't go up, and that's where we're focused," she said. 
 
 Asked whether she was willing to alter the terms of the agreement, Murray replied: "No. We have a deal; we're moving it forward." 
 
 Some Democrats said they have no reservations about trying to solve a problem that, in their view, was created by Trump and for which his party will be blamed if Congress takes no action. 
 
 "We know doing this will be good for the country," said Sen. Sherrod Brown (D-Ohio). "I hope that people here aren't that cynical, that, 'Why would you do it just because it's good for the country?' " 
 
 But conservatives were already mobilizing to block the measure, which would authorize CSR payments for two years. The framework would also allow insurers to offer catastrophic insurance plans to consumers 30 and older on Affordable Care Act exchanges while maintaining a single risk pool. It would shorten the period for federal review of state waiver applications; expedite reviews for states in emergency circumstances and those with waiver proposals that have already been approved for other states; and allow governors to approve state waiver applications rather than require state legislative approval. 
 
 Susan B. Anthony List President Marjorie Dannenfelser, whose political action committee backs antiabortion candidates, described the proposal Wednesday as "an inadequate, shortsighted approach which fails to address the abortion funding problems created by the health-care overhaul." 
 
 "Right now nearly 900 health-care plans subsidized by taxpayer dollars cover abortion, forcing taxpayers to be complicit in the destruction of human life," she said. "In no way does the Alexander-Murray bill fulfill Republicans' campaign promise to repeal and replace the ACA." 
 
 A handful of Senate Republicans have expressed support for the plan, including Mike Rounds (S.D.), John McCain (Ariz.) and Bill Cassidy (La.). But Senate Majority Leader Mitch McConnell (Ky.) has not committed to bringing it up for a floor vote, and some GOP senators questioned Wednesday why they should keep funding the subsidies. 
 
 "Well, I don't want to just vote to put paint on rotten wood," Sen. John Neely Kennedy (R-La.) told reporters. "I just want to understand what the benefits are. I understand the money going out the door." 
 
 Several key House Republicans said they don't see how the bill would win passage in their chamber. 
 
 Many senior White House officials oppose the bill, according to administration officials and Republicans who have been briefed on the matter. At times, Trump's aides have been sidelined as he has conferred with Alexander, according to one Republican, fueling confusion about the state of negotiations. 
 
 The bipartisan plan does enjoy support among patient rights groups, although they have raised concerns about whether the flexibility it offered could raise health-care costs. On Wednesday, the American Cancer Society Cancer Action Network endorsed it. 
 
 "This deal offers important, immediate action to stabilize the individual insurance market," said the group's president, Chris Hansen. "Restoring $106 million per year in outreach and education programming would help to reduce public confusion over the law and ensure more people who need health coverage get it." 
 
 Even as elected officials and interest groups debated in Washington how to handle cost-sharing payments, attorneys general from 18 states and the District of Columbia filed a motion in the U.S. District Court for the Northern District of California seeking a temporary restraining order and a preliminary injunction that would require the administration to continue making the payments to insurers. The attorneys general argued that the court order was needed "to prevent immediate and irreparable harm to the Plaintiff states and the millions of Americans who benefit from affordable health coverage under the ACA." 
 
 While Schumer made no predictions as to whether the bipartisan agreement would actually make it to Trump's desk, he held out hope that the president could serve as an ally in the end. 
 
 "This president keeps zigging and zagging," Schumer said on the floor. "Our only hope is maybe tomorrow, he'll be for this bill." 
 
 John Wagner, Jordan Frasier and Paul Kane contributed to this report. 
 
 Read more at PowerPost
– In a move that analysts say could be a devastating blow to ObamaCare, President Trump is ending one of the health care bill's crucial subsidies. White House press secretary Sarah Huckabee Sanders confirmed Thursday night that the federal government will stop "cost-sharing reduction" payments to health insurers, which help millions of people afford insurance they get through ObamaCare's exchanges, Politico reports. Sanders called the payments a "bailout of insurance companies" and "another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system." Related coverage: The impact: The Washington Post likens the decision to "throwing a bomb into the marketplaces" created by ObamaCare. Insurers have said this is the strongest step Trump could take to undermine the law, because rising costs would force them to bail without the promise of getting reimbursed. The alternative could be to remain, but to raise premiums to levels most couldn't afford. The New York Times also calls the subsidies "essential" to the Affordable Care Act. Trump's possible offer: "The Democrats ObamaCare is imploding," the president tweeted Friday morning. "Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!" The last part might be the most telling. The Wall Street Journal reports that Trump has told at least one lawmaker that he's open to preserving the payments if a bipartisan deal is struck on health care. All eyes on this: Trump is referring to a deal being negotiated by GOP Sen. Lamar Alexander and Democratic Sen. Patty Murray. Under the broad strokes, the subsidies would be continued, a win for Democrats, but states would get more flexibility to avoid ObamaCare rules, a win for Republicans, per the Journal. Big deadline: Open enrollment for the ObamaCare exchanges begins in less than three weeks, raising pressure for a quick resolution. Background: A federal court declared the subsidies illegal last year, though the decision is being appealed. The subsidies add up to around $7 billion this year, a figure expected to steadily rise in coming years. The attorneys general of California and New York vowed Thursday night that they would challenge the latest move in court, while Nancy Pelosi and Chuck Schumer called it "a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America." Second move: Earlier Thursday, Trump signed an executive order that's expected to undermine ObamaCare in a different way.