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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The Trump Administration has been looking for lifeboats for Americans trapped in ObamaCare exchanges, and one project is to expand “association health plans,” or AHPs, that let employers team up to offer coverage. But the fine print in the proposed Labor Department rule is causing concern and needs to be cleaned up.

The issue is whether the Trump rule will let association health plans set prices based on risk, which is how insurance is supposed to work. The point of the rule is to let businesses enjoy the flexibility that large employers have under a law known as Erisa. Under the Affordable Care Act bigger businesses have fared much better than those stuck in the small group market, which is heavily regulated.

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After 94-year-old Enid Stevens was treated for a spinal fracture at a hospital in Northern England last month, she was wheeled out from the overcrowded ward to a hallway, where she lay on a gurney, unable to easily alert nurses, for six days.

“The health service is failing,” said Wayne Stevens, Mrs. Stevens’s 40-year-old grandson. “It’s not just my grandmother—there are thousands, if not hundreds of thousands, of grandmothers going through the same indignities.”

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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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