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“In the vast majority of metropolitan areas across the country, health insurers hold outsized market share -- leaving patients with fewer choices and higher costs,” said Dr. John M. Whyte, CEO and executive vice president of the American Medical Association.

For self-funded plans, the path forward should be one that is proactive, rather than reactive.

Trump said that while he still preferred a plan that would give Americans direct subsidies to purchase insurance, an agreement to reduce costs could help preserve the Obamacare exchanges.

The ICHRA plan participants themselves have flowed between insurers and plans in what looks like an orderly fashion, without big, frightening surges of enrollees into underpriced or overly generous plans.

"If there is no extension provided, rising marketplace premiums could significantly impact employer-sponsored health plans," said Cole Harris, the president of CBIZ Benefits & Insurance of Tennessee.

Health care leaders are taking a strategic approach to nursing compensation this year, a survey by the consulting firm SmithCotter found.