The Trump administration has indicated it will make this month's cost-sharing reduction payments to health insurers, according to news reports yesterday. Insurers use the federal payments to reduce out-of-pocket costs for low-income individuals purchasing coverage through the Health Insurance Marketplaces. The Congressional Budget Office this week estimated that premiums for silver-level plans would be 20% higher in 2018 and 25% higher in 2026 if the payments were to end. The U.S. Court of Appeals for the District of Columbia Circuit this month allowed 15 states and the District of Columbia to intervene in the House v. Price lawsuit, which challenges the CSR payments, because they would suffer concrete injury if the payments ended. In a friend-of-the-court brief last year, the AHA and other hospital groups said ending the CSRs would harm patients’ finances and health, trigger a “death spiral” in the marketplaces, and force hospitals to shoulder an even greater financial burden, making it harder for them to serve their communities.