Worked like it did in other countries and we had a risk pool shared with healthy, younger people who currently pay an arm and a leg for private health insurance that they will no longer have when they are old and sick. People who aren’t impoverished enough to qualify for Medicaid and aren’t old enough to qualify for Medicare make “decisions” about what they’re willing to pay for, and are often uninsured. The O-Care mandate was supposed to shrink those margins considerably and did — but Republicans have waged a decade’s worth of scorched earth warfare to blow it up and ensure it doesn’t work.

With no mandate, O-care is likely doomed to failure so Congress will either need to fix that issue or go with a Medicare for All approach where the end result would be tens of millions of people scrapping their private insurance and going with the public option. I’m OK with that, but would have preferred to fix O-Care. I don’t trust the Republicans to do either. They literally would rather see millions die than the Democrats get to claim successful healthcare reform and history has born that out, sadly enough.