Democrats generally favor a state public insurance option again this year, while Republicans support reinsurance to cushion the costs of high-need patients. They’re both fine ideas that could help, but they won’t solve the underlying problems. Controlling premium costs is going to take a range of smart solutions that target the drivers of rising costs. Health care utilization isn’t up, and declining health and rising age don’t explain it. There is growing evidence that the actual prices for care are to blame.