One part of the Affordable Care Act that never really took off is now going to be dropped by the Trump administration. Multi-state insurance plans allowed under the law are not going to be administered by the Office of Personnel Management anymore.
The law allowed for two multi-state private insurance policies that would be available nationally through the exchanges in every state. That was intended to make sure that there were no states that had no coverage options. But by 2017, there was just one of these plans and it was only being offered in one state, Arkansas. The administration is trying to spin this as a signal that Medicare for All would never work, with one official telling Axios it was "a pilot program for the public option, and it's been a dismal failure with even the most liberal states balking on it."
Except it's not at all that because it was private insurance companies that were supposed to be doing it. And none of them wanted to. They didn't want to have to negotiate with insurance commissioners and hospitals and doctors to create the multi-state networks that would have been required to make it work.
Which is a big problem for Republicans should the federal courts decide to side with Trump and strike down the whole of Obamacare. Because the one bid idea Republicans have kept talking about as the main thing in the "replace" part of repeal and replace is allowing insurers to sell insurance across state lines. This is yet more proof that that's something insurance companies have no interest in doing. They're going to have to find another worthless big idea to hang their hats on now.