Twenty-one states have taken no action to stabilize the individual insurance market created under the Affordable Care Act (ACA) and improve access to health insurance coverage, an interactive map from the Commonwealth Fund shows. What Is Your State Doing to Affect Access to Adequate Health Insurance? examines which of eight policy actions states have taken to promote access: 1) operate a waiver-funded reinsurance program; 2) implement an individual mandate requiring health insurance coverage; 3) provide premium and cost-sharing subsidies; 4) regulate the sale of short-term coverage more strictly than the federal government does; 5) extend open enrollment periods; 6) establish rules to promote a competitive ACA marketplace; 7) prohibit the sale of non-compliant transitional policies on the individual market; and 8) not exempt other coverage from insurance rules. According to the map, thirteen states have taken one policy action to promote access, one state has taken two, six states have taken three, and six states and the District of Columbia have taken four or more. In addition, Iowa, Kansas, and Tennessee have exempted certain health plans from federal and state rules for individual market insurance taken — a policy action likely to reduce access to coverage in that it tends to encourage market segmentation and lower the quality of the ACA-compliant risk pool, which in turn makes comprehensive individual market coverage less affordable and accessible.