I would say this is inaccurate. They got burned by Congress allowing employer based groups to exist, therefore removing much of the healthy population from the insurance pools for the public (whose employers don’t offer insurance, or who aren’t employed). If everyone was dumped on healthcare.gov, there would be plenty of healthy lives to offset the sick lives for a viable insurance group. Maybe not in the smallest states, but it hasn’t made sense to me to separate insurance by state either.