To date, nearly all proposals to replace or amend the Affordable Care Act (ACA) would give significant flexibility to state officials and rely heavily on implementation by state insurance regulators.
A report commissioned  by the Consumer Representatives to the National Association of Insurance Commissioners (of which Consumers Union is one) discusses concerns about the market destabilization these proposals portend without a responsible replacement plan for the Affordable Care Act in place:millions of consumers expected to lose their coverage, leading to significant premium increases, threats to insurer solvency, withdrawals from the marketplaces or individual market, and, potentially, the collapse of state insurance markets. This report discusses the need for consumers to access high-quality health insurance products— regardless of whether and how changes are made at the federal level– as well as the progress that has been made in reducing the uninsured rate since 2010 and identifies guiding principles for policymakers when considering further changes to the market.