Senate Republicans will lose their ability to repeal Obamacare without any Democratic votes at the end of this mont. The Senate parliamentarian ruled that budget reconciliation process would expire at the end of September, the last day of this fiscal year.
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The Senate may not need to act at all if Trump strangles funding for the existing program. They’ve already cut funds for the next enrollment and shortened the time period. It could be death by a thousand cuts.
The final deadline for insurers to file their rates and decide whether they will stay in the Marketplace Exchange for 2018 is September 27th.
Even without a repeal, which seems unlikely, GOP have already done a fair amount of short-term damage. Thankfully, their efforts to sabotage the ACA aren’t crippling nor causing it to implode… yet.
Most insurers have probably locked-in their rates by now, although some still might pull out of the Market at the last minute depending on what Trump and Congress decide to do.
There’s a large amount of shuffling going on; right now there are only 2 bare counties with zero coverage (one each in Wisconsin and Ohio), which affects ~500 people total. However, greater than 1,400 other counties (45% of counties in the U.S.) serving 2.5 million Marketplace participants are “at risk” with only one insurer remaining (although with multiple health insurance plan options).
Many insurers have already taken into account the uncertainty caused by Trump. They expect a weak and reluctant (or possibly wholly uncommitted) response to supporting the ACA, so they’ve bumped up their costs accordingly.