In another life I was a property and casualty insurance underwriter. I would assess risk and figure out if premiums for a given area were enough or too much. Was the company too exposed to hurricane damage? What about earthquakes? Balancing risk with premium was the name of the game.
Given my background I have never understood how Obamacare was going to “work.” Obamacare seemed (and is) an adverse selection machine. The sick are more likely to sign up and the healthy have shied from the program for any number of reasons.