Obamacare isn’t in a death spiral and repeating the claim, and citing markets with one or few carriers in the marketplace as evidence won’t make it so.
As a starting point, the very notion of a singular thing called Obamacare “collapsing” is conceptually flawed. “Obamacare” could collapse as a whole in theory, if it were designed much more haphazardly than it is. But the truth on the ground is nearly the opposite.
Obamacare isn’t one thing at all: It’s dozens and dozens of markets across the country, the compositions of which vary by region. Some of these markets are thriving, others are not; they are not collapsing en masse, and, thus, neither is Obamacare. To the contrary, the design of Obamacare makes it nearly death spiral-proof, because it insulates most consumers from premium increases, by linking subsidy levels to income and premium prices. Thus, even where single companies dominate, costs to consumers can be fairly stable.
The CBO does say that markets under AHCA would eventually stabilize, so it isn’t intellectually honest for people who don’t like Trumpcare to say Trumpcare will destroy insurance markets, just because we don’t want AHCA to pass. But the CBO also says that, under current law, “subsidies to purchase coverage combined with the penalties paid by uninsured people stemming from the individual mandate are anticipated to cause sufficient demand for insurance by people with low health care expenditures for the market to be stable.”
In other words, Obamacare isn’t “collapsing” or in a “death spiral,” and when Ryan, President Donald Trump and other Republicans say otherwise, as they often do unchallenged, they are lying.