(Credit: AP/Charles Rex Arbogast) With members of Congress spending the month of August in their home districts, Republican efforts to do away with President Obama’s signature legislative achievement, the Affordable Care Act (ACA), appear stalled, at least temporarily. However, the Trump administration still appears committed to unraveling the ACA. Most prominent are the threats to withhold cost-sharing reductions, which reduce out-of-pocket payments for low-income consumers on the insurance marketplaces. According to the Congressional Budget Office, cutting these payments would drive up health insurance premiums by 20 percent while costing the federal government close to US$200 billion over a decade. Ultimately, the future of the ACA remains murky at best, leaving blue states scrambling for alternatives.