Of course it did. The ACA was based upon the notion that requiring young, healthy Americans to buy insurance would make it possible to provide coverage to older, less healthy folks and people with pre-existing conditions at an affordable rate. Young people are simply opting not to do so in numbers that would make it feasible for the plan to work. They'd rather pay the fine than the premiums. Additionally, the ACA had built into it "risk corridor payments" where companies that assumed an unprofitable share of risk due to taking in more older and less healthy clients were supposed to receive payments from companies that were profitable. In 2014, there were very few companies in that situation due to higher costs and less premiums from healthy people. As a result, instead of $90 million coming to Moda from that program, they received only $11 million. In short, the ACA was built as a house of cards and the ones at the base aren't holding up the structure. It's going to come crashing down unless Congress does something to shore it up. That something will no doubt be very expensive and very unpopular.