As Trump attacks Federal Health Law. Some States Shore it Up

Nationwide, premiums for average-priced policies — according to a Kaiser Family Foundation analysis — offered on and off the health insurance exchanges created under the Affordable Care Act rose by more than a third compared with 2017. The biggest statewide hikes were in Iowa (88 percent), Utah (78 percent), New Hampshire (78 percent), Wyoming (72 percent), and Virginia (66 percent). The underlying cause of the rate hikes is clear: efforts last year by the Trump administration and its allies in Congress to dismantle the Affordable Care Act — and promises of further attempts in the year ahead.California, Connecticut, the District of Columbia and Maryland are considering legislation that would recreate the Affordable Care Act’s individual mandate by requiring nearly all residents to enroll in a health plan or pay a fee. Massachusetts has a mandate on the books that it said it intends to enforce.Taking a different tack — one that has been endorsed by members of both political parties — Alaska, Minnesota and Oregon have created so-called reinsurance programs designed to cover higher-than-average claims with state money and thereby reduce overall risk for insurance companies so they can offer consumers lower premiums.