The goal of this project is to inform federal and state policy discussions about how best to stabilize the individual health insurance market. Since 2015, many insurers have incurred financial losses associated with operations in the individual health insurance market attributed largely to the scale and complexity of ACA-induced changes and implementation challenges associated with the ACA’s risk stabilization programs. This has resulted in premium increases, insurer exits from local markets or entire states, and fewer plan choices among remaining insurers. In response, several states have undertaken reinsurance efforts using finding from section 1332 State Innovation Waivers, a strategy the current CMS administration has supported. The researchers will characterize patterns of insurer exit from the individual market and affected populations, estimate the impact of insurer exit on premiums and plan offerings 2015-2018, and investigate efforts in Alaska, Minnesota, and Iowa to use section 1332 State Innovation Waivers to fund new state reinsurance programs. Deliverables will include a project work plan and final narrative and financial reports. The grantee will also produce paper(s) suitable for publication and present findings at national research meetings and other to stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels, as part of the deliverables for this grant.