18 July 2017 - Pennsylvania insurance commissioner Teresa Miller visited all five of the health insurance companies selling plans on her state's Affordable Care Act exchanges earlier this year and said the conversation was almost identical at each one.

After a year in which companies had complained of huge financial losses and made dramatic exits in some states, things were looking up in Pennsylvania, the insurers told Miller. Last year, they'd received a 32.5% premium increase, on average, but they were cautiously optimistic they would make a far more modest request for 2018. There was one big caveat: the turmoil in Washington.

“If you take Washington out of the picture, our market is really stabilising,” Miller recalled hearing from the companies. In June, the companies followed through on their optimism, requesting premium increases of just 8.8% on average.

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