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Anthem Inc. made preliminary filings indicating it will offer plans on the Affordable Care Act marketplaces in Virginia and Kentucky next year, providing an early signal on the insurer’s exchange business. Cigna Corp.and Aetna Inc., which like Anthem have said they are reconsidering their exchange offerings, are among the insurers that made similar filings in Virginia. But one current Virginia ACA insurer, UnitedHealth Group Inc., didn’t file 2018 forms, and a spokesman confirmed it would leave the state’s marketplace next year. (Wilde Mathews and Radnofsky, 4/20)

President Trump is pressuring Congress to sink parts of the Affordable Care Act. But now that the first attempt at a GOP health-care overhaul has failed, he must decide whether to throw the law a line. The White House and Republican lawmakers are facing key decisions that could either improve the insurance marketplaces established by the ACA next year or prompt insurers to further hike rates or withdraw from those marketplaces entirely. Republicans had hoped to protect those with marketplace coverage while lawmakers replaced Obamacare. (Winfield Cunningham, 4/19)

The deadline to keep the federal government open is just about here, but a deal is far from done. With just five workdays left until government funding expires, lawmakers return next week to all the same sticking points that have made full-year funding so elusive and now threaten a government shutdown.  ... Democratic leaders declared that any spending bill must provide money for a key Obamacare subsidy program after Trump threatened to defund the cost-sharing subsidies; the president sees the program as a way to force Democrats to the negotiating table. (Scholtes and Ferris, 4/20)

Democrats’ demand that ObamaCare subsidies be wrapped into a must-pass spending package is complicating GOP efforts to prevent a government shutdown at the end of next week. Speaker Paul Ryan (R-Wis.) has signaled no plans to include the subsidies in a bill to keep the government open, but President Trump’s recent threat to withhold the subsidies to insurers has led several top Republicans to intervene. (Lillis and Marcos, 4/19)

Rural areas would be hit particularly hard if Congress and the Trump administration don’t send clear signals that they’re committed to helping keep ObamaCare’s insurance marketplaces stable next year, advocates warn. Insurers are in the midst of deciding which ObamaCare markets to enter, and they need assurances that they won’t have to pay billions for out-of-pocket costs for certain low-income consumers. Rural areas already have fewer care options than their urban peers.  (Roubein, 4/19)