Researchers at the Urban Institute and Georgetown University analyzed the strategies of 11 states to reduce "rate shock" and found officials were taking different approaches to protecting consumers.
The study found:
-- Maryland and Oregon established their own reinsurance programs with state funds to better control premium costs.
-- Colorado, Minnesota and Alabama began transitioning people with pre-existing conditions out of high-risk pools into plans with younger, healthier people.
-- Maryland, New York and Oregon are protecting against insurers undercutting the exchanges by "locking them out" in subsequent years if they don't participate in year one -- as well as limiting the sale of catastrophic plans.
-- Maryland, New York, Oregon and Colorado also standardized broker compensation inside and outside the exchange to prevent customers from being steered away from one market toward another.
"The Affordable Care Act provides a number of protections to shield consumers from dramatically increased premiums," Katherine Hempstead, who leads coverage issues at the Robert Wood Johnson Foundation, said in a statement. "Many states are going above and beyond to safeguard consumers against high insurance rates."
The report was prepared as part of the ACA Implementation -- Monitoring and Tracking Series.