The Trump administration has been arguing for months that the health insurance market reforms of the Affordable Care Act (ACA) are not working and are even harming consumers. But four years of data on Americans’ experiences in a reformed individual market provide considerable evidence to the contrary, says The Commonwealth Fund’s Sara Collins in a new post. The marketplaces’ current problems, she says, stem from lack of certainty about the administration’s actions regarding enforcement of the ACA's insurance market reforms, rather than the reforms themselves.