The Montana Healthcare Foundation retained Wakely Consulting Group, LLC, to analyze the potential effects of a state-based reinsurance program on the 2020 individual Affordable Care Act market. MHCF, the Montana Department of Administration, and the Montana Department of Health and Human Services are interested in exploring policy options that will keep individual health insurance premiums affordable for Montanans. In the last two years, Montana’s individual ACA market has experienced double-digit premium increases and enrollment has decreased significantly. To address instability in the individual market, MHCF requested that Wakely analyze how a state-based reinsurance program for the 2020 benefit year might impact the individual market. In particular, Wakely analyzed how a potential reinsurance program would impact premiums in 2020, what the potential pass-through might be if the state pursues a reinsurance-based 1332 waiver, and potential reinsurance payment parameters for select funding scenarios.