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Republicans have ripped a big hole in Obamacare. But there is a way to avoid chaos in the health-insurance markets on which millions of Americans depend, if states act quickly to undo the damage.

Democrats based Obamacare on a careful trade-off. The government would no longer tolerate insurance companies denying sick people coverage or needed care. But Congress would also mandate that all Americans carry adequate health-care coverage, as long as they could afford it, in order to ensure that people did not sign up for insurance only when they got sick. With both healthy and sick people paying into the insurance pool, medical risk would be spread broadly and everyone’s premiums would be reasonable. If, on the other hand, healthy people opted out, premiums would be much higher, risking instability and even an insurance-market “death spiral.”

Opinion | States can fix Republicans’ Obamacare mess

They should pass their own individual mandates that apply within their borders.


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