The Affordable Care Act (ACA, aka Obamacare) is still the law of the land, but the Trump administration has modified so many of its provisions — including the elimination of a tax penalty for not having health insurance — that the remaining parts of the ACA are forcing some states, and even citizen initiatives, to come up with legal remedies to what could be called Trumpcare.

states-move-to-augment-trumpcareNew Jersey has already passed legislation to institute its own individual mandate — be covered or pay a penalty — along with additional legislation to create a reinsurance pool to cover any catastrophic health-related expenses of its citizens.

Now, the District of Columbia is following suit to pass similar legislation, but unlike the Garden State’s plan, the D.C. law would exempt people below a certain income threshold. Connecticut, Hawaii and Vermont are eyeing similar legislation.

Vermont’s plan might go even a step further by instituting a health care auto-enrollment process. Ohio, however, is going the exact opposite direction by petitioning the Department of Health and Human Services (HHS) to eliminate the individual mandate entirely in the state.

There’s movement on the Medicaid expansion front as well.

A citizens’ initiative in Utah will trigger a November ballot referendum on whether Medicaid coverage should be expanded under terms of the original ACA. Some 165,000 voters, 50,000 more than needed, signed the ballot initiative. If passed, 150,000-plus low-income individuals would be eligible for Medicaid coverage.

”People want more health care — not less,” Jonathan Schleifer, executive director of the Fairness Project, a left-leaning economic justice group that is helping support the initiative, said in a statement. “They are done with politicians who are not addressing their top concerns, and they are taking action to do something about it.”

Last year, Maine became the first state to see voter-approved Medicaid expansion. Voters in Idaho face an April 30 deadline for a similar initiative, but supporters say they already have more tha enough signature.