Julie Rovner

The Trump administration is refusing to defend key parts of the Affordable Care Act, essentially arguing that federal courts should find the health law's protections for people with pre-existing conditions unconstitutional.

The federal lawsuit hinges on the ACA's individual mandate, or the requirement to get health coverage or pay a penalty. The mandate has long been a sticking point for conservatives, who argue that the government should not be telling individuals what coverage they must have.

The Affordable Care Act very nearly failed to become law back in 2010 because of a dispute among Democrats over how to handle abortion in the bill.

Now a similar argument between Democrats and Republicans is slowing progress on a bill that could help cut soaring premiums and help stabilize the ACA.

At issue is the extent to which the Hyde Amendment — language commonly used by Congress to prohibit most federal abortion funding — should be incorporated into any new legislation affecting the health law.

A bipartisan group of senators and House members has been working since last summer toward measures to keep prices from rising out of control and undermining the individual market—the market that serves people who don't get insurance through work or through the government. Members hope to attach a package of fixes to what should be the year's final temporary spending bill, due late this month.

As a presidential candidate, Donald Trump promised abortion opponents four specific actions to "advance the rights of unborn children and their mothers."

One year into his presidency, three of those items remain undone. Nevertheless, opponents of abortion have made significant progress in changing the direction of federal and state policies.

A day after President Trump said the Affordable Care Act "has been repealed," officials reported that 8.8 million Americans have signed up for coverage on the federal insurance exchange for 2018 — nearly reaching the 2017 number in half the sign-up time.

That total is far from complete. Enrollment is still open in parts of seven states, including Florida and Texas, that use the federal HealthCare.gov exchange but were affected by hurricanes earlier this year.

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