Maryland could face a big “October Surprise” this fall when more than 150,000 residents who buy health insurance on the state’s exchange learn their premiums will increase as much as 50 percent. Inability on behalf of Congress to repeal the Affordable Care Act (ACA) combined with the long, slow erosion of Maryland’s health exchange is forcing state policymakers to find ways to protect residents from a painful sticker shock. 

At the federal level, the Trump administration has taken a variety of actions toward the ACA that gives Maryland and other states the opportunity to innovate in how they regulate health insurance and health care, as well as how they administer Medicaid. Regulators and legislators should take advantage of this federal leeway by allowing consumers greater freedom to purchase insurance that meets their needs and budgets, reforming Medicaid to contain costs and prioritize the neediest recipients and giving more opportunities for health care professionals and facilities to serve consumers in Maryland.