Repeal and replace is on-again, off-again, but that doesn’t mean the rules affecting your insurance will stay the same in the meantime.

The Trump administration late Thursday issued a final rule aimed at stabilizing the existinghealth law’s insurance marketplace that could have rapid, dramatic effects — perhaps as soon as early summer — on people who do not get insurance through work, and buy it on the Affordable Care Act’s exchanges instead.

The final rule upholds much of what was proposed by the administration in February, including a shorter enrollment window, tighter vetting of people who sign up outside of those open periods and efforts to require some consumers to show proof of prior insurance coverage.

The controversial proposal by the Department of Health and Human Services drew letters from nearly 4,000 organizations and individuals during an unusually short, 20-day public comment period that ended in early March. In their comments, consumer advocacy groups decried the proposal, saying it would wreak havoc by making it harder to get coverage. Insurers were generally supportive.

But some specialists in the health law, including Christopher Condeluci of CC Law & Policy in Washington, D.C., saw the initial proposal released in February by HHS as helpful for insurers, though he also thought more adjustments were necessary.

“Does it meet all the carriers’ asks when it comes to what changes are needed? No, I don’t think it goes far enough,” said Condeluci, a former staffer to the Senate Finance Committee who specialized in insurance issues.

Sabrina Corlette, an attorney who studies the individual marketplace for the Center on Health Insurance Reforms at Georgetown University, said the directive could result in fewer healthy enrollees — which insurers also would not like — and doesn’t address some of the biggest concerns for the insurance industry, such as the fate of federal subsidies that help low-income consumers pay deductibles and other out-of-pocket costs.

The Trump administration’s proposal, Corlette said, is “nibbling away at the margins.”

She could not be reached late Thursday for comment on the final version.

Here are four ways the stabilization rule might change the individual health insurance market:

If you owe, you pay first

The final rule, to be published in the Federal Register next week, saysconsumers who want to sign up for an ACA plan with their same insurer for 2018 would have to repay past-due premiums from the previous 12 months before being granted new coverage. Because Obamacare has allowed a three-month grace period before people who haven’t paid premiums are kicked out of coverage, a consumer’s overdue premiums could tally hundreds of dollars — even more than $1,000.

The proposed change aims to discourage people from gaming the system. Insurers say a person with a bad knee, for example, might enroll and pay just long enough to get an expensive knee replacement, then stop paying premiums.

But wait, consumer groups and the National Association of Insurance Commissioners warned in their comment letters: There might be legitimate reasons people stop paying premiums — billing errors that are not the fault of the consumer, for example, or the loss of a job. By making such a change, the groups argue, the Trump administration violates a key part of the health law that requires insurers to offer coverage to just about everyone who applies.

“Only those who can rapidly come up with a possibly significant sum of money by a given deadline can be guaranteed access to coverage,” wrote Families USA.

Better act quickly

Open enrollment this fall (for 2018 health insurance coverage) would shorten to six weeks, down from three months. While opening day would remain the same — Nov. 1 — the final rule closes the marketplace on Dec. 15 instead of at the end of January. That period “provides sufficient time for consumers to enroll,” the administration has said, and would mean all who sign up would have a full year of coverage starting Jan. 1.

The shorter time period, the administration said, could also reduce the number of people who wait to enroll until after they find out they have a health problem. These late joiners are likely to use more health care than a healthy person their age, insurers and the Trump administration say, and can drive up the cost of insurance to everyone.

Consumer groups argue the Trump plan could backfire, because those who tend to wait until the last minute to sign up are actually often the youngest and healthiest — and they may miss the enrollment window if it is shorter. Additionally, the deadline falls around the holidays, when money and time are often tight, which could have a chilling effect on insurance sign-ups.

Prove you have a reason — and maybe prior coverage

The ACA allows people to sign up outside the open enrollment period for a variety of special reasons, such as moving, losing coverage, getting married or having a child. This provision has always been a sticking point with insurers, who have maintained that too many customers who made a change during the special enrollment period were sicker and costlier than average. In response, the Obama administration tightened some of these requirements last year and announced it would run a pilot program starting this summer to randomly select half of all special enrollment applicants for verification review, holding up the applicant’s insurance coverage until they provide the proper documentation.

Under the new rule, 100 percent of those applications would be required to undergo preapproval verification — beginning in June 2017. Consumers will have to provide documentation proving they qualify for special enrollment before getting coverage. The rule also says that for marriage, at least one member of the couple would have to prove they had health coverage for at least one day in the two months before their nuptials.

Consumer groups are unhappy with the pre-verification idea — and the extra requirement of prior coverage for people who have gotten married. Particularly hard-hit would be couples who were uninsured previously because they could not afford health insurance as singles or could not get it under their state’s Medicaid rules. Additionally, consumer advocates and some regulators say requiring newlyweds to prove prior coverage violates the health law.

Flexibility — or higher deductibles?

The health law uses a complex formula to divide plans into metallic tiers — bronze, silver, gold and platinum — based on an average percentage of a typical year’s health care bills that each level of plan covers. Bronze plans, for example, currently must cover an average of 60 percent of costs, while a silver one is 70 percent. Insurers are allowed wiggle room of plus or minus 2 percent around those averages.

The Trump rule tweaks the formula, allowing insurers to create plans with larger variations around the average. (It exempts certain silver plans for low-income consumers from the change.) So, for example, a bronze plan might cover only 56 percent of costs and silver 66 percent. Insurers say this would allow them to create plans that appeal to more customers, particularly those looking for lower premiums. But critics say the move would increase the size of deductibles.

One big problem in boosting enrollment has been that many potential consumers — particularly younger, healthier ones — say premiums are too high. But adjusting the law in this way could raise deductibles and other cost-sharing requirements, which consumers may dislike even more. While the health law sets a maximum cap per year on such payments, for many people those deductibles are already thousands of dollars annually. Under the proposal, deductibles could increase by more than $1,000 a year, according to an analysis by the consumer advocacy group Families USA.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

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United Airlines announced that it will compensate all passengers who were on board United Express Flight 3411 Sunday night. That’s the Chicago-to-Louisville flight in which a 69-year-old man was dragged off the plane by airport police officers because he didn’t want to give up his seat.

United spokeswoman Megan McCarthy says the compensation will equal the cost of passengers’ tickets and will come in the form of cash, travel credits or miles.

Earlier in the day, United Airlines CEO Oscar Munoz told ABC’s Good Morning America that the company would never again use law enforcement officers when it decides to to remove passengers from a flight.

United personnel had asked for volunteers to give up their seats for four airline employees who were needed in other cities. Three passengers left. Kentucky physician David Dao refused.

Munoz said he felt “ashamed” of the incident which was video-recorded and went viral. “This will never happen again on a United flight. That’s my premise and that’s my promise,” he said.

Munoz offered an apology to Dao, his family and other passengers on the flight. The United CEO had previously referred to Dao as a “disruptive and belligerent passenger” in an internal company communication. That reaction was widely panned as exacerbating United’s PR nightmare.

But when asked by ABC whether the passenger was at fault in any way, Munoz replied, “No, he can’t be. He was a paying passenger sitting on our seat, in our aircraft and no one should be treated that way. Period.”

In a statement issued on the airline’s website yesterday, Munoz said “It’s never too late to do the right thing.”

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It’s a cliché that happens to be true: Bears love honey. And in Maryland, lawmakers have passed a bill making it legal to shoot a black bear if it threatens a beekeeper’s hive.

In February, state Del. Mike McKay testified before the Environment and Transportation Committee on behalf of the bill. He wore a vest festooned with the image of Winnie the Pooh.

Del. Herb McMillan noted McKay’s attire didn’t seem to square with his arguments. “I know you came in here talking about Winnie the Pooh, but the gist of the bill is that you can shoot him,” McMillan said, according to The Baltimore Sun.

Existing Maryland law requires a person to have a hunting license and a black bear hunting permit in order to hunt black bears in the state. Exempted is “a person who kills or wounds a black bear in defense of his/her own life, the lives of other individuals, or the lives of animals on the individual’s property.”

This week, Maryland’s General Assembly passed McKay’s bill. So, if the measure is signed by the governor, as of June, the exemption on hunting bears will extend to the owners of honeybee colonies, if the owner has contacted the state’s Department of Natural Resources and installed an electric fence to protect the hive. The measure also provides funds to provide electric fences to beekeepers.

The DNR says it receives about six reports of damage to bee colonies annually, although could be things other than bears. The state has a Black Bear Damage Reimbursement Fund, and it says it gets approximately two claim requests per year.

“We’re concerned about the beekeepers who raise bees for honey and other agricultural uses,” Del. McKay explained in a video interview with the Sun in February. “We know that black bears do attack them, and we just need to figure out a way we can protect the investment, because it is livestock. If a black bear is hurting a lamb or a calf, you have the right to shoot that because it is your investment and your livestock. We just want to extend the same to those who are in the beekeeping industry.”

Four counties in western Maryland have breeding populations of black bears; the state estimates its population of black bears to be more than 1,000. One thousand bears lusting for honey.

“The proverbial bull in the china shop is no comparison to a bear in the beeyard when it comes to damage and destruction,” warns the state’s Department of Natural Resources.

If you’ve got a bear in your beeyard, the Maryland DNR recommends a four-strand electrical fence, with a small piece of bacon coated with honey or molasses affixed to it.

But Allen Hayes, president of the Maryland State Beekeepers Association, says that electric fences aren’t always effective in deterring bears, especially if the ground is very dry. His organization backed McKay’s bill.

If bears really want the hive, says Hayes, “they have been known to take the shock to the get the reward on the other side.”

Eric Mussen is Emeritus Extension Apiculturist at the University of California, Davis. He says that bears have a pretty good sense of smell, and they can catch the scent of a beehive if they get downwind of a nearby colony. “If the colony is living in a tree, often the bear literally tears the tree apart to get to the bees,” he writes in an email to NPR.

Once a bear gets into a colony, Mussen says, it will eat a little honey, but it will devour the bee “brood”: bee eggs, larvae, and pupae — a source of protein and fat.

Bears bring that same appetite — for brood and destruction — to man-made beehives.

“They leave the covers scattered all over; the hive boxes scattered and often broken; the combs pulled out, broken, and strewn about in the apiary; and the combs that had brood in them will have the comb eaten out,” writes Mussen. “The colony will not survive and there may be very little undamaged equipment to salvage.”

“To a small-scale beekeeper, the financial loss is not too severe,” Mussen adds. “However, losing the colony, that requires so much effort to keep healthy these days, is quite a blow. For commercial operators, who may not revisit the apiary for a couple weeks, it can mean very substantial economic loss.”

The Maryland legislature has been squarely in the bee camp lately. Last year lawmakers passed the Pollinator Protection Act, which bans consumers from buying pesticides that contain neonicotinoids, which are believed to harm bees. The Associated Press reports that Maryland beekeepers lost nearly 61 percent of their hives in 2015, about twice the national average.

“A beekeeper has the right to protect his or her property in an extreme situation,” Hayes said. “The state legislature obviously agrees with us.”

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