Donald Trump’s decision to halt cost-sharing reduction payments to insurersproviding coverage on the Affordable Care Act exchanges was one ofthe key factors sparking insurers' decision to boost rates, whichhave risen anywhere fom 7 to 38 percent, according to an analysis by the Kaiser Family Foundation.

Repeated threats by Trump since his inauguration to end thecontroversial CSRs, say the analysis, made insurers wary that hemight actually do so. In addition, his refusal to see that theindividual mandate was enforced made them even more nervous—so theyplanned rate hikes for 2018 to compensate.Without the CSRs or mandate enforcement, they stood to lose someserious money on policies covering the poorest and sickest ofcustomers.

Since insurers are obligated to offer reduced cost sharing viasilver-level plans to low-income consumers withincomes up to 250 percent of the poverty level regardless ofwhether CSRs are paid, they had to make their decisions, finalizepremiums and sign contracts before the September 27th deadline ifthey still wanted to offer coverage on the ACA’s federalmarketplace.