The Affordable Care Act is in trouble because Republicans refused to tweak the system as problems cropped up.
Another problem is the introduction of competition in the insurance marketplace. Consumers finally had a chance to compare insurer plans side-by-side, forcing insurance companies to provide lower premiums to get their business. But that hurt their bottom line, and they left the exchanges. Real comparison shopping for insurance in the individual private market is impossible, which is why many sought out insurance agents for advice.
The three other biggest reasons? Republican Sabotage:
1. See, Insurance Companies are Leaving the Exchanges…ObamaCare Failed?
Rep. Marco Rubio severely limited the supposed "bailout fund" in the Affordable Care Act for what are called called risk corridors, a temporary aid for insurers to adjust premiums.
Rubio helped persuade Congress to prevent Health and Human Services from being able to cover expenses in its own budget. But experts have said Rubio is wrong to call the program a bailout, and that the program is supposed to pay for itself through fees from insurers.
2. See, since CBO wrongly estimated ACA enrollment, can't believe 24 million will lose insurance? Only 32 states expanded Medicaid, instead of all 50 states after the Supreme Court struck down the coverage mandate. That blew a hole in the CBO estimate:
3. See, Medicare is Going Broke, so now we have to Privatize to Save It:
A key Ryan change would repeal a Medicare tax on high earners a year earlier than originally proposed. Obamacare imposed an additional payroll tax of 0.9% on individuals earning more than $200,000 and couples earning more than $250,000 (among other changes to Medicare) … leading to about $10 billion of lost revenue. “Here you have a bill where Congress is voting to actively undermine the trust fund, and it’s singularly for the purpose of providing tax breaks for the wealthy,” says Stacy Sanders, federal policy director for the Medicare Rights Center.