The Affordable Care Act shifted power from state insurance commissioners and consumers to the federal government. This has resulted in less affordable care. After falsely promising people they could keep their health plans, President Barack Obama responded to the ensuing political backlash by letting people renew their “grandmothered” plans bought after the ACA was signed but before exchanges opened. Democrats responded to higher premiums by increasing subsidies and removing the upper-income limit, shifting costs to taxpayers.

Still, states can enact laws to provide alternative health benefit coverage. Legislators can provide relief from Obamacare’s onerous regulations without a federal repeal or court case. While Democrats pointed to these mandates as generous, many complained about having to pay higher premiums for coverage they did not want. Young men and older women criticized higher premiums for maternity benefits they did not need, for example.