I tried to make my post as factual and non-partisan as I could (I acknowledge the partisan comment in the last statement, but even that is factual).
I don't see the issues facing the system as the result of obstructionism. The law was written based on the assumption that if states didn't set up their own exchanges, the federal exchange system would pick up the slack. That assumption was heroic when it was made but it could prove to be tragic as time unfolds.
I think the risk going forward is a product of the calculated risk taken by the program's architects: That the millenials would enroll in sufficient numbers and the mandates would produce enough healthy enrollees to allow the insurers to accept higher risk enrollees, comply with the coverage mandates and balance the equations.
People are always going to make purchasing decisions based on their own economic self interests. If I need/want it and I can afford it, I will buy it. If I don't need it, don't want it or I can put off purchasing it until I will afford/want/need it (like, on the way to the ER), then I won't get it. That is, so long as the penalty for not playing is less painful than the cost of playing.
I don't think the architects fully took that into account.
Worse, I think the current move to extend enrollment deadlines and suspend the individual mandate will make the likelihood of a downward spiral even greater. It's not partisanship or ideology at work here--it's economics and actuarial science.
Edit to add: Insurers are very good at setting rates that minimize their risk exposure, and they will take every uncertainty into account when doing so. The more they sense unforeseen risk in their pools, the more likely they'll increase rates to minimize or mitigate that risk. There are subsidies built into the law that allow them to receive a credit from the government because of risk-based losses, but they'd just as soon let the market bear the cost of the additional risk and not have to worry about filing a ream of paperwork with HHS.
I'm actually quite cynical about the paucity of grandfathered individual market plans. HHS wrote those regulations, knowing full well that the fewer grandfathered plans existed, the more consumers would be driven to the exchanges and the more likely that the calculated risk would pay off.
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