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Early last year as an Obamacare repeal bill was flailing in the House, top Trump administration officials showed select House conservatives a secret road map of how they planned to gut the health law using executive authority. The March 23 document, which had not been public until now, reveals that while the effort to scrap Obamacare often looked chaotic, top officials had actually developed an elaborate plan to undermine the law — regardless of whether Congress repealed it. (Haberkorn, 1/10)

An internal Trump administration document shared with Republican lawmakers last year shows officials' plans to change ObamaCare through administrative actions, in what Democrats say is evidence of “sabotage” of the health law. The one-page document lists 10 actions the administration planned to take to make conservative-leaning changes to how the law is implemented. It was shared at a meeting with House GOP lawmakers on March 23, in the heat of the effort to win votes for the House’s ObamaCare repeal measure, which was pulled the next day. (Sullivan, 1/10)

Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) met Wednesday to discuss the path forward for their bipartisan legislation aimed at stabilizing ObamaCare, aides in both parties said. The legislation’s future has been thrown into question after it was punted at the end of last month. Alexander is now pushing for the legislation to be included in a government funding package when a long-term deal on that measure is reached. (Sullivan, 1/10)

The lesser known of two bipartisan Senate bills aimed at stabilizing the individual health insurance market is the one policy experts say would have a greater influence on lowering premium costs at this point. But supporters worry the bill may continue to stall in Congress while states are looking for guidance. The measure from Sens. Susan Collins, R-Maine, and Bill Nelson, D-Fla., would provide funding for states to set up reinsurance programs or high risk pools, which policy experts say could help drive down premiums. But while lawmakers are focused on issues like funding the government and immigration, experts say now would be the time for Congress to take up that legislation before states and health insurers begin preparing for the 2019 plan year. (McIntire, 1/10)

Insurers on Wednesday renewed their fight to claw back billions of dollars in unpaid risk corridor payments, telling a federal appeals panel that the government legally can't default on its obligation when Congress takes away the money stream. Three judges from the U.S. Court of Appeals for the Federal Circuit homed in on the government's argument that Congress essentially redefined the intent of the Affordable Care Act's risk corridor provision by limiting what funds could go towards the payments. (Luthi, 1/10)

The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate. The CMS posted the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House's OMB to continue an annual data collection from exchange plans about the risk profile of their enrollees. (Dickson, 1/10)

During the three years that the government collected a tax on sales of medical devices, Maple Grove's Inspire Medical Systems never turned a profit on its sleep apnea treatments. CEO Tim Herbert says the company could have had 12 to 15 more employees if that tax money, which helped pay for the Affordable Care Act, had stayed in-house. (Spencer and Carlson, 1/10)

Republicans successfully repealed the Affordable Care Act’s individual mandate through their tax reform legislation, which has created many questions for consumers. How will this decision affect insurance markets and consumers’ ability to get coverage? Without additional legislative action, there are three things we can expect. With the individual mandate repealed, many healthy people will drop their coverage. This will likely lead insurers to expect to lose money, and they will either exit the individual market or raise premiums. As a result, there will be increased pressure on Congress to come up with a solution before consumers’ access to coverage is reduced.(Tolbert, 1/10)

Enrollment activity is picking up at the state’s MNsure health insurance exchange in advance of Sunday’s deadline for individuals to buy 2018 coverage. On Monday, the number of online shopping sessions at the MNsure website hit its highest point since last month’s deadline for coverage that started Jan. 1, said Allison O’Toole, the MNsure chief executive. People who sign up for coverage between now and Sunday would have health plan coverage as of Feb. 1. (Snowbeck, 1/10)