The policy players now trying to improve or replace the current Affordable Care Act system are facing a familiar enemy: anti-selection.

An insurance market is a little like a plate spinning in the air. Infusions of premium dollars, fee revenue, investment income and any government subsidies help balance the effects of claim payments and keep the plate spinning.

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Allison Bell

Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.