Two of Virginia’s ObamaCare insurers are requesting significant premium hikes for 2019, according to initial filings released Friday.

Both Cigna and CareFirst BlueCross BlueShield cited policies advocated by the Trump administration, including the repeal of ObamaCare’s individual mandate, as part of its justifications for the increases.

Cigna is proposing an average premium increase of 15 percent for its 103,264 customers in Virginia, with a range of increases from 6.4 percent to 40 percent.

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This fall’s midterm election ballot just got a little longer in Utah. In mid-April, progressive activists announced that they’d gathered enough signatures to force a November referendum on Medicaid expansion.

Utah isn’t the only red state flirting with extending free government health insurance to able-bodied, childless adults. Within weeks, activists in Idaho will surpass the number of signatures required for their own ballot referendum. Groups in Nebraska just launched a signature-gathering campaign, too.

If voters choose to expand Medicaid, they’ll surely regret it.

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House lawmakers quickly voted to continue New Hampshire’s expanded Medicaid program Thursday, spending almost no time debating one of the session’s biggest policy issues.

The current program uses Medicaid funds to purchase private health plans for about 50,000 low-income residents, but it will expire this year if lawmakers don’t reauthorize it. The bill approved Thursday would continue the program for five years but change its structure to a more cost-effective managed care model. The plan also would impose new work requirements on enrollees and use 5 percent of liquor revenues to cover the state’s cost as federal funding decreases.

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Supporters of Medicaid expansion sued Maine on Monday to force state officials to implement the voter-approved law that has been held up by Gov. Paul LePage, who has stalled it for months while imploring the Legislature to first fund it on his terms.

In doing so, they put Attorney General Janet Mills on the hot seat, with a lawyer saying the suit will end quickly if the Democratic gubernatorial candidate and frequent foe of the Republican governor agrees with them because she controls the state’s legal representation.

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Idaho is poised to allow a vote on Medicaid expansion after an activist group said it has collected enough signatures to put it on the November ballot.

Reclaim Idaho said it has collected the required 56,192 signatures needed to place the measure on the ballot. The deadline to turn in the signatures is Monday.

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Republicans should impose two parameters on any block-grant proposal

  1. States can be given enormous freedom to deviate from Obamacare, so long as people who come to the individual market after paying premiums for group insurance for many years can buy insurance that is similar to what employers offer for a similar premium. (I have previously described how I think this could be done.)
  2. States can offer limited benefit insurance(buying whatever the tax credit will buy and allowing auto-enrollment and potentially insuring an additional 30 million people) provided that they set aside safety net money to take care of the really expensive cases ($1 million premature baby, for example.)

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This year could mark a significant shift for Medicaid programs across the country, as some states look to expand the government insurance program to more poor Americans while others seek to add more requirements for people who benefit.

Initiatives to get Medicaid expansion put on the November ballot are underway in Utah, Nebraska, Idaho and Montana. And Virginia lawmakers appear on the verge of securing an expansion deal, after years of rejecting the idea.

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Connecticut lawmakers are considering two bills that would impose fines on people for choosing not to buy health insurance.

The Connecticut state House Insurance and Real Estate Committee sponsored House Bill 5379 (H.B. 5379), which would require residents who do not purchase health insurance to pay a fine of $10,000 or 9.66 percent of their annual income, whichever is higher.

Connecticut state Rep. Joe Aresimowicz (D-Berlin) sponsored House Bill 5039 (H.B. 5039), which would levy a fine of $500 or 2 percent of annual income on individuals who decide not to buy health insurance.

H.B. 5039 was approved by the Connecticut General Assembly’s Joint Insurance and Real Estate Committee in March and made available for consideration in the full House of Representatives on April 9. The committee also held a March 2 public hearing on H.B. 5379 but did not vote on the bill.

The Connecticut House has not yet scheduled a vote on either bill.

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Louisiana’s health insurance market for individuals has been plagued in recent years by insurers fleeing the market and double-digit rate increases — prompting a proposed fix that would tack a fee on policies across the state to create a safety net against insurers’ losses and hold the line on runaway premiums.

The state Department of Insurance is pushing a bill through the Legislature that it says would lower premiums in the individual market by an average of 15 percent next year. The bill would put a roughly $1.25-a-month fee on every health-insured life in the state. That money, which one critic labeled a tax on business disguised as a fee, would go into what is called a reinsurance pool designed to protect insurers against high-cost patients.

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As goes Iowa, so goes the nation — or at least that’s the conventional wisdom during presidential elections. Let’s hope the same rule applies to healthcare reform.

Earlier this month, Iowa Gov. Kim Reynolds signed a law that takes advantage of a major loophole in Obamacare. The legislation, based on a similar effort in Tennessee, enables any Iowan to enroll in a “health benefit plan” sponsored by the Iowa Farm Bureau. Due to a legal technicality, the plans aren’t subject to Obamacare’s premium-inflating regulations.

The reform is a laudable attempt to give consumers an affordable alternative to the plans for sale on Obamacare’s exchanges. Until Congress makes good on its promise to repeal and replace the law, other states can liberate their residents from the law’s financial burdens by following Iowa’s lead.

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