State officials are struggling to finalize 2018 premiums by the end of this month in the face of continued White House indecision over whether to reimburse insurance companies for Affordable Care Act cost-sharing reduction (CSR) plans, which make it easier for low-income Americans to afford their marketplace coverage. As Georgetown University’s Sabrina Corlette and Kevin Lucia explain in a new To the Point post, state insurance commissioners have given insurers different directives. For example, some states have required or allowed insurers to assume they won’t be reimbursed for CSR plans in 2018, while others are asking for two sets of rates — or not providing any directives.