By Justin Giovannelli, JoAnn Volk, and Kevin Lucia

Though most states’ individual markets are experiencing a second year of stability, premiums and cost-sharing continue to impose significant financial burdens on many Americans. Regulatory changes by the Trump administration to promote limited coverage products not governed by Affordable Care Act (ACA) rules, as well as continuing legal threats to the ACA itself, have challenged state lawmakers from across the political spectrum to explore options for safeguarding and improving their residents’ coverage.

In 2018, we examined what states had done to improve access to comprehensive individual market coverage in seven key policy areas over which they exercise authority. We documented policy initiatives including the establishment of waiver-supported reinsurance programs, financial incentives for individuals to maintain coverage, and increased oversight of skimpy, short-term insurance products. In a new brief for the Commonwealth Fund, we update our analysis with attention to state efforts to strengthen individual market coverage in 2019 and policy changes contemplated for the year to come. You can access our full analysis here.