All insurance involves everyone paying, and some using. To call that a subsidy is an effort to shift the attention and portray it a certain way.
The insurance companies segment and price the individual market differently than the large group market. They currently define group by gender, age, region, state, and health condition, break them down into hundreds of segments, and price each differently. This [-]is a failed model because it[/-] excludes so many and is punitive on some that move between sub-group.
The large group market defines groups differently, with fewer segments and far less granularity. This market works much more smoothly for sponsors and users. The ACA is attempting to make the individual market work more like large group insurance, where the primary driver of difference in premium is coverage.
Individual group coverage will continue to define sub-groups with more segmentation. Age is still a factor, as is region. It is still critical shift, however, away from a model where the key driver of price is exclusion.
While many measures have already been fully implemented, it is fair to say that one key test is new enrollment. The key to success in not getting more young people to enroll, it is getting all people to enroll, and making the individual marketplaces more like a large group market.