Donald Trump is causing insurers in the Affordable Care Act individual market to raise their premiums more than they would if the federal government simply enforced the ACA as is:
Insurers assuming the individual mandate will not be enforced have factored in to their rate increases an additional 1.2% to 20%. Those assuming cost-sharing subsidy payments will not continue and factoring this into their initial rate requests have applied an additional rate increase ranging from 2% to 23%. Because cost-sharing reductions are only available in silver plans, insurers may seek to raise premiums just in those plans if the payments end. We estimate that silver premiums would have to increase by 19% on average to compensate for the loss of CSR payments, with the amount varying substantially by state [Rabah Kamal et al., “An Early Look at 2018 Premium Changes and Insurer Participation on ACA Exchanges,” Kaiser Family Foundation, 2017.08.10].
ACA tax credits will protect many marketplace policyholders from those premium increases, just as the tax credits have protected them from the increases that Noem, Rounds, and Thune keep mistakenly bleating about. The costs are distributed among taxpayers… but the fact is that insurers are having to spend more money to maintain their business model due to the uncertainty introduced by Trump.