insurance providers that offer coverage through the affordable care act (ACA) marketplace - otherwise referred to as Obamacare, are reportedly already preparing for President Trump to cancel monthly cost-sharing reduction (CSR) payments. In early September, the Connecticut Mirror reported that insurance providers Anthem and ConnectiCare got the approval of the Connecticut Insurance Department to raise their rates for individual policyholders in the event that he does.

Providers, states prepare for threats to ACA

While the state of Connecticut doesn't use the ACA, the insurance providers under their state exchange - Access Health CT - are still subsidized under the Patient Protection and Affordable Care Act (2010).

According to NBC News': "Obamacare repeal failed, but some of the damage is already done," regulators from other states such as Michigan and Mississippi are approving rising rates anticipated by those providers as well. These increased premiums will certainly continue to play into the Republican Party's stance that Obamacare is "failing" because the cost of premiums is too high.

As of July, when it seemed that Senate Republicans had failed to repeal the law for the last time, President Trump acknowledged that he could kill Obamacare by himself by canceling the CSR payments. Despite not being able to kill Obamacare through Congress -- and still funding monthly CSR -- the Trump administration has already started cutting funding for advertisements that would promote the upcoming enrollment period for the ACA for 2018 which begins on the first of November.

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Republicans determined to cripple insurance providers through the ACA

There is no doubt that Republicans are determined to end Obamacare no matter how many times they fail to do so. With the end of the deadlines reached for both insurance providers to join the exchanges, for Republicans to repeal the ACA under congressional reconciliation rules and with the enrollment period to start in November; Republicans will try to repeal Obamacare again starting in January. That's because they will be able to use the rules of reconciliation again (which expired on September 30. Republicans would then have another chance of passing a repeal bill using the majority of the seats that they hold rather than the traditional 60 threshold.

Like the repeal effort, the bipartisan talks between senators Lamar Alexander (R-TN) and Patty Murray (D-WA) to fix the ACA were "frozen" by Sen. Orrin Hatch. But, unlike the repeal effort, both senators have started up talks again and could continue to try and get support pass it.

House Speaker Paul Ryan, however, has already shown no interest in voting on such a bill and even said that they would not vote for it in the House and President Trump has also said that he would veto it. And yet, after the repeal effort failed, Trump did say that he would try to work on health care with Democrats, perhaps to spite the conservative party, leaving Americans with even more uncertainty.