1. By REED ABELSON and HAEYOUN PARK NY Times JUNE 6, 2017
Obamacare Didn’t Destroy Insurance Markets, but It Also Didn’t Fix Them
By REED ABELSON and HAEYOUN PARK 
NY Times
JUNE 6, 2017

2. Where do people get insurance?
Most Americans get health insurance from a job or government program, but about 8 percent, or some 22 million people, now buy individual policies under the Affordable Care Act. Insurers began offering these plans in 2014.

3. More or less competition?
Supporters of the Affordable Care Act hoped the law would spur more competition among insurers across the country.
But so far, the law has not delivered on that promise, especially in states that never had much competition, but it didn’t create the lack of choice in those states, according to a Times analysis of insurer participation provided by the Robert Wood Johnson Foundation.

4. States w/ some competition
2013
2017 MA MA WA WI NY WA WI MI NY OR OH PA OR IL OH PA CO CA CO VA TX GA TX GA FL FL
Stayed that way … and vice versa

5. States w/ some competition
2013
2017 MA MA WA WI NY WA WI MI NY OR OH PA OR IL OH PA CO CA CO VA TX GA TX GA FL FL
Stayed that way … and vice versa

6. Big states, small states
Big states like Pennsylvania and Texas, with major cities, have always appealed more to insurers because they offer a large pool of potential customers, and the companies can strike better deals with some of the hospitals and doctors.
But states with more rural populations and poorer residents tend to struggle because insurers are reluctant to enter markets where there are fewer customers that may be costly to cover.

7. Like big firms, small firms
Big firms can do a lot of risk pooling.
Small firms have a more difficult time.

8. What is insurance? You bet you will get sick.
Insurer bets that you won’t.
If you gamble, how does a bookmaker make money?
Discuss.