@Yet anbother anonymous coward... Re: @Orv
No offense, but your comment doesn't make sense.
Every group is part of a risk pool. Its not the existence of a risk pool that's the issue.
My company is a small company so its grouped together with other small companies in the same plan as a way to establish a risk pool. IBM is large enough that not only could it self insure itself, but it could be its own risk pool.
Your insurance rates are based on factors like age, and medical expenses.
The ACA capped the ratio of expenses between the young and the old causing the insurance premiums on younger adults to increase significantly more than older folks however overall they went up for everyone.
The issue wasn't the existence of a risk pool. The issue was that companies came on to the exchanges pricing insurance with no prior history to base their actuarial formulas. Obama promised to make the insurance companies whole, with funds he didn't have. So the insurance companies under priced for the actual risk and lost BILLIONS. Now these insurance companies that got in to the game with Federal Loans, got hammered and all have gone under. Because insurance is regulated by the states, they can only raise premiums by a certain percentage each year, so in year 2, they also lost billions.
The reason they lost billions is that the young healthy people didn't want to pay for something that they didn't want or need. They could have purchased a catastrophic insurance policy that would meet their needs. So the risk pools got skewed and more 'unhealthy' older people jumped on the insurance.
So its not the issue of having risk pools, but the insurance companies not being able to manage their risks. Obama et al thought that could balance the risk by forcing younger people in to buying something that they didn't need. Didn't work out.
This is why the ACA is DOA. There are one or two counties where you can't buy insurance because no one is offering it. In most markets only BC/BS is offering policies once UHG pulls out. And if BC/BS pulls out... what happens when you can't buy insurance and the law requires it?
This is why Trump and the Republicans have an opportunity to fix things. Only problem is that while they agree that ACA is crap, they can't agree on how to fix the damage.
There's so much more but its hard trying to explain it when many here don't have a grasp on both sides of the industry.