There have been national reports of extreme increases for this year in health insurance exchange premiums, largely due to Trump administration policies. Not surprisingly, a new analysis by the Urban Institute for the Robert Wood Johnson Foundation finds that states with more competition among insurers and more options for consumers have the lowest premiums. Connecticut’s experience was mixed. In good news — the average lowest silver plan for 40-year-old nonsmoker here rose 24.7% from 2017 to 2018 while the national increase averaged 32%. But we are still an expensive state; our least expensive silver plan premium is 21% higher than the US average. The least expensive gold plan premium in CT rose 34%, much higher than the US average of 19%. In sum, CT’s exchange record remains very mixed.