ObamaCare largely outlaws charging less to younger or healthier people and more to older, less-healthy ones; insurers have gamed this rule by only offering plans in select areas, plainly those where they believe the underlying demographic and socioeconomic trends will allow them to come out ahead.
A recent survey by Credit Suisse looked at 36 federally-run exchanges, plus six state exchanges where data was available. It found that Aetna is offering health plans in just eight of these 42 states — and is even more selective in the counties where it chose to play. In Florida, for example, Aetna was only operating plans in 23 of the state’s 67 regions. (In most of the country, state regulators long ago designated “regions” for insurance-pool purposes; the new system pretty much sticks to those maps.)
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