The Administration’s actions last week to disrupt the Affordable Care Act (ACA) marks a new chapter in the Republican repeal effort. The cost-sharing reductions (CSRs) that plans receive to cover lower-income individuals will no longer be paid meaning insurers will lose money for the final three months of this year and the indefinite future, creating implications for the upcoming year if plans decide to no longer participate in the marketplace. This decision follows immediately behind the Administration’s executive order to direct agencies to consider expanding coverage through Association Health Plans (AHP) and short-term limited duration insurance plans. These actions coupled together send rippling effects across the Marketplace and issuers.