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Nearly three weeks after Republican infighting sank an overhaul of the Affordable Care Act, President Donald Trump dug back into the battle on Wednesday, threatening to withhold payments to insurers to force Democrats to the negotiating table. In an interview in the Oval Office, Mr. Trump said he was still considering what to do about the payments approved by his Democratic predecessor, President Barack Obama, which some Republicans contend are unconstitutional. Their abrupt disappearance could trigger an insurance meltdown that causes the collapse of the 2010 health law, forcing lawmakers to return to a bruising debate over its future. (Bender, Radnofsky and Nicholas, 4/12)

Those payments to lower-income people, called cost-sharing-reduction subsidies, have been at the center of an almost three-year legal battle between Republicans and Democrats. The payments are used to help poorer people in Obamacare afford copays and other cost sharing for medical services. Without them, they might not be able to afford to get care. Trump’s administration has threatened to stop making the payments. (Pettypiece and Tracer, 4/12)

Democrats are adamant that they won’t negotiate on subsidies, which lower medical costs for nearly 7 million Obamacare customers. “Failing to make these payments would be a direct effort by the administration to further undermine the health care system in this country, putting care for millions of Americans at risk,” said Matt House, a spokesman for Senate Minority Leader Chuck Schumer. "President Trump has an obligation to drop his attempts to repeal the Affordable Care Act, and instead work with Democrats to strengthen it.” (Diamond and Dawsey, 4/12)

A coalition of eight health groups is making a direct appeal to the Trump administration and congressional leaders to fund the Affordable Care Act’s cost-sharing reductions for this year and next, calling it “the most critical action” that could be taken to stabilize health insurance exchanges. The future of the payments has been a source of uncertainty for insurers, who are preparing their policy proposals for the ACA exchanges in 2018. (McIntire, 4/12)

Leading healthcare industry groups are urging Republicans to fund key ObamaCare payments that could lead to chaos if discontinued. Groups including America’s Health Insurance Plans, the American Medical Association, and the American Hospital Association wrote letters to President Trump and congressional leaders saying the payments, known as cost-sharing reductions should continue. (Sullivan, 4/12)

“Without funding of the (cost-sharing reductions) by Congress and the administration, there could be a ripple effect in the individual insurance market raising coverage costs for everyone,” said a statement by Chip Kahn, President and CEO of the Federation of American Hospitals. (Pugh, 4/12)