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The ACA requires insurers to reduce deductibles and co-pays for low-income buyers on the individual insurance market, and it requires the government to reimburse the insurers for those reductions; but because the ACA didn’t specifically provide an appropriation for the payments, congressional Republicans have maintained that they can’t be made. In other words, the payments are mandated by law, and also illegal (and unconstitutional). President Trump cited this argument on Oct. 12, when he said through his press office that “the government cannot lawfully make the cost-sharing reduction payments.”... But that raises an important question: If the payments are illegal, why did the Trump administration make them every month after it took office, from February through September? (Michael Hiltzik, 10/20)

After a season of healthcare policy fits and starts, now is the time for Washington to take a collective deep breath and assess what we learned and how we as a nation can do better. I say "we" because if the objective is truly a high-performing, affordable health system for all Americans, then everyone has a role to play—patients, providers, purchasers, health plans and policymakers of every stripe. ... Market stabilization is central to long-term success. (Ceci Connolly, 10/21)

Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) on Thursday formally introduced their proposal to shore up the Affordable Care Act’s private insurance markets. And in a show of the proposal’s bipartisan strength, they announced the bill now has 24 sponsors, with precisely 12 from each party. It will take that kind of support to push the proposal through Congress, given many Republicans’ feelings about anything related to “Obamacare,” not to mention the contradictory statements President Donald Trump has made lately. (Jonathan Cohn, 10/19)

As the debate unfolds about the bipartisan bill by Senators Lamar Alexander and Patty Murray to repair the Affordable Care Act marketplaces, the public could be just as confused as they have been about the ACA's marketplaces. That's why it's important to debate it in the right context: It's aimed at an urgent problem affecting a relatively small sliver of the health insurance system, not all of the ACA and not the entire health system. The bottom line: It's a limited measure that will never give conservatives or liberals everything they want. (Drew Altman, 10/23)

After failure to repeal and replace Obamacare comes retribution, but not against White House staff or U.S. senators. Instead, President Donald Trump is punishing millions of American families by jacking up premiums and letting skimpy health plans flood the marketplace. (Daniel Zingale, 10/20)

The president is required by Article Two of the Constitution to “take care that the laws be faithfully executed.” So are his efforts to undermine the Affordable Care Act unconstitutional? Particularly since Congress, which is empowered to write American laws, declined to make similar changes to the Obama-era health law when Trump urged legislators to do so, most of the framers of the Constitution would presumably be appalled by these actions. (Scott Lemieux, 10/18)