Why Are Insurers Dropping Out of the Affordable Care Act

The vast majority (about 85 percent) of exchange customers nationwide qualify for the program's tax credits and cost-sharing subsidies because their incomes are below four times the federal poverty threshold.

Those eligible for that assistance tend to be sicker than those who don't qualify because those with comparatively low incomes have poorer health on average than people with higher incomes.

Obamacare bars insurers from keeping more than 20 percent of premium income from insurance sales in the individual market to cover marketing costs, administration and profit. Before Obamacare, all companies could keep more, and many did.

Some insurers face heightened financial risks because an unusually large proportion of Obamacare exchange customers are new customers — 50 percent of Aetna's 2016 enrollees, for example. In the old days, insurers could question new customers and charge very high premiums to those having characteristics associated with high health-care use. No longer.

The Affordable Care Act allows premiums to vary by only a few factors, such as the age of the insured.

f the exchanges were merged into one big marketplace for individual health insurance coverage.

In order to sell insurance in an exchange the price insurers charge non-exchange customers for a given plan has to be the same as what they charge Obamacare customers.

Sounds fair to me.