Insurance companies are warning that uncertainty in the health insurance marketplace – resulting directly from the Trump Administration’s actions (or inaction) – is going to make premiums more expensive for Americans and their families. Insurance companies from states across the country said that uncertainty around whether or not the Administration will enforce the individual shared responsibility provision or pay the Cost Sharing Reduction (CSR) subsidies is resulting in large double-digit rate hikes and “the beginning of a death spiral.” These proposed rate hikes should be no surprise to the President, as the Democratic Leaders of the House and Senate sent him a letter in March outlining actions the Administration must take to stabilize the marketplaces.