Open enrollment for 2019 health plans begins Nov. 1 on HealthCare.gov and on most state insurance exchanges. Healthcare.gov via Screenshot by NPR hide caption

Grant Burningham, who lives in Bountiful, Utah, worked to get a referendum on Medicaid expansion on the Utah ballot in November. Kim Raff for NPR hide caption

Shelton Allwood joined other demonstrators in Miami last year calling for continued protection for people who have pre-existing medical conditions. Joe Raedle/Getty Images hide caption

Organizers with Idahoans for Healthcare have been driving this green vehicle around the state to campaign for Medicaid expansion. Phil Galewitz/Kaiser Health News hide caption

As Sen. Joe Manchin, a Democrat from West Virginia, campaigns for re-election, he has warned that 800,000 West Virginians with pre-existing conditions could lose health coverage. Drew Angerer/Getty Images hide caption

Sutter Health Alta Bates Summit Medical Center, in Oakland, Calif. is one of hundreds of hospitals serving poor patients that will get some reprieve from Medicare's readmissions penalties. Smith Collection/Gado/Getty Images hide caption

Demonstrators held signs outside the U.S. Capitol in Washington DC on June 26, 2018 while Democratic leaders called on the Trump administration to uphold the preexisting conditions provision of the Affordable Care Act. Now the issue may be decided in court. Aaron P. Bernstein/Getty Images hide caption

Despite the political uncertainties, insurance companies have started to learn how to make a profit on the plans they offer through the Affordable Care Act. Erik McGregor/Pacific Press/LightRocket via Getty Images hide caption

If you earn too much to get a subsidy to help defray the cost of health insurance, you might find a less expensive policy off an exchange. PeopleImages/Getty Images hide caption

Changes from the Centers for Medicare and Medicaid Services could affect how some hospitals operate. David Sacks/Getty Images hide caption

President Trump, pictured in July 2017. Four cities are suing Trump and his administration for allegedly undermining the Affordable Care Act in violation of the Constitution. Alex Brandon/AP hide caption

Short-term health care plans could be a more affordable option for some consumers, but they're exempt from covering people with pre-existing conditions. Dreet Production/Alloy/Getty Images hide caption

Senate Majority Leader Mitch McConnell (from left), Supreme Court nominee Brett Kavanaugh and Vice President Pence met on Capitol Hill Tuesday, ahead of meetings with Republican senators. Democrats vow to challenge Kavanaugh's nomination in upcoming hearings. Chip Somodevilla/Getty Images hide caption

Charlie Wood of Charlottesville, Va., plays with bubbles during a May 4, 2017, rally near the Capitol to oppose proposed changes to the Affordable Care Act. Charlie was born a few months prematurely, and her mother, Rebecca (left), fears changes to the health law will negatively affect her care. Tom Williams/CQ-Roll Call Inc. hide caption