My name is Sherry Glied, and from 2010 to 2012 I was the assistant secretary

for planning and evaluation at the department of Health and Human Services

in the Obama administration.

When you think about whether the Obamacare is collapsing,

I think you really have to sort of think about the current situation and the counterfactual.

Would it naturally collapse or is it collapsing in part because

the administration is causing it to collapse.

Premiums last year that is coming into this year's cycle,

increased quite a lot.

There are couple of things administration has done that may be contributing to

weak performance of exchanges.

The first thing is that

when almost the first thing that the Trump,

the president Trump did when he entered the office is to put out

an executive order saying that they would not be

strenuously enforcing the individual mandate.

So that likely led to some reduction in signups

He also turned off the marketing spigot a little bit earlier this year than had been done in prior years.

But the most important concern, I think,

in terms of stability and future of these markets is that

they are supposed to have stream of money come in

to pay for reductions in the cost sharing for low-income subscribers.

So, the way that the Affordable Care Act is set up,

if you are low-income person and you buy a health plan,

that health plan gets an extra subsidy so that

your deductibles, your cost sharing, what you have to pay when you go to the doctor, isn't too high.

There's been an argument between Republican congress and President Obama

when he was still in office about whether the money that was flowing

under that piece of the legislation had correctly followed Congressional rules.

But, President Trump has not been clear about whether he will let those payments flow or not.

If the payments don't flow,

insurers will be responsible for giving better coverage to low-income people,

but they won't be subsidized for that.

And they're building that into their premiums, and raising them accordingly.