A health plan ‘down payment’ is one way states are retooling individual mandate


Proposals have been discussed or advanced in at least nine states, including California, Washington, Connecticut, and the District of Columbia.

Creating an individual mandate is just one way that states – generally blue states where Democrats control the legislature – seek to ensure that what many lawmakers view as key advances made by the ACA don’t disappear.

They’re looking to one another as test cases to see how state-level legislation can either buttress or alter the ACA, according to Trish Riley, the executive director of the National Academy for State Health Policy.

“One state will try one approach; others will try it,” Riley said. “It’s an experiment, and an important one.”

Time is short, since most states have limited legislative calendars and are fast approaching the deadlines for insurers to file their 2019 rate plans.

Passing and implementing these kinds of measures will be tough, said Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute. But “I think there’s still a window of opportunity for states to do something and have an impact on 2019 premiums,” she said.

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