The average cost of employer health coverage offered to workers rose to nearly $20,000 for a family plan this year, according to a new survey, capping years of increases that experts said are chiefly tied to rising prices paid for health services.

Annual premiums rose 5% to $19,616 for an employer-provided family plan in 2018, according to the yearly poll of employers by the nonprofit Kaiser Family Foundation. Employers, seeking to blunt the cost of premiums, also continued to boost the deductibles that workers must pay out of their pockets before insurance kicks in

When Republicans tried to repeal the 2010 health care law last year, Democrats knew they had an issue that would define this election cycle. A year and a half later, health care is still dominating Democratic messaging.

Take New York’s 19th District, which stretches  where GOP freshman John J. Faso faces Democratic lawyer Antonio Delgado.

“Everywhere I travel across this district, and it’s big, there’s no doubt that health care is the most important issue on people’s minds,” Delgado said at a recent candidate forum here in the sprawling upstate district. “We’re in crisis.”

As Democrats enter the final sprint in a campaign where health care is a dominant issue and a House takeover seems achievable, they are split on whether to promise coverage for everyone, which would fuel an already revved-up liberal base, or target centrist voters by campaigning on the more modest goal of fixing the Obama-era health law.

Centers for Medicare and Medicaid Services Administrator Seema Verma on Wednesday cited reduced Obamacare premiums and expanded choices as evidence that the Trump administration has not “sabotaged” the healthcare law, as charged by Democrats.

“For the very first time, rates have [been] going down… I think we have been successful in that area,” Verma said at an event hosted by the Economist Group in D.C.

The Health Care Choices plan would let Idaho find its own solutions to help the working poor.  The state would receive a formula grant and gain new flexibility to approve policies that are more affordable than Obamacare.

If Idaho votes instead to accept Medicaid expansion, taxpayers, the privately insured, and especially those who need traditional Medicaid would pay an unfortunate price.

Obamacare’s individual mandate has been paid 19.6 million times, forcing Americans to send $8.4 billion to Washington. Over 80% of penalty payers made less than $50k/year.

Obamacare premiums are expected to drop 2 percent nationally next year, and the total number of insurers on the federal exchange will grow for the first time in four years, Health and Human Services Secretary Alex Azar said Thursday during remarks in Nashville.

Azar credited President Donald Trump for the improving insurance marketplace, saying that Trump had proven “better at managing” the Affordable Care Act, known widely as Obamacare, than the law’s namesake.

A top health official in the Trump administration defended Medicaid work requirements Thursday, arguing that its intent isn’t to expel people from the program.

“Community engagement requirements are not some subversive attempt to just kick people off of Medicaid,” Seema Verma, head of the Centers for Medicare and Medicaid Services, said in a speech in Washington, D.C. “Instead, their aim is to put beneficiaries in control with the right incentives to live healthier, independent lives.”

Small Business Owners say that the most important issue affecting them is the cost of health care, according to the National Small Business Association’s annual Politics of Small Business Survey.

When asked what issues they raised most with elected officials, 40 percent of the surveyed owners said health care costs. Local issues were second on the list at 28 percent and tax reform came third with 37 percent.

Maine’s Republican governor has said federal regulators want to know how Maine would pay for Medicaid expansion. But it’s unclear just how that issue will play out in Maine, the first state to pass Medicaid expansion under Republican President Trump’s administration.

States must file routine paperwork to get federal Medicaid expansion funding under former Democratic President Obama’s signature health care law. The Centers for Medicare & Medicaid Services told The Associated Press on Tuesday that it works to ensure states pay for their share of an expansion with “proper” financing.