What the ACA really did to health insurance markets

This smart presentation from the NYT is getting a lot of attention because its conclusions about the individual health insurance market under the Affordable Care Act are so simple:

• Claim: The ACA will increase competition and choices across the country (from supporters).
• Reality: Nope.
• Claim: The ACA is destroying health insurance markets across the country (from opponents).
• Reality: Nope.

The bottom line: There are states that face real crises with insurers pulling out, like Iowa. But for the most part, the states that are having trouble keeping insurers never had a lot of competition to begin with. And the states with thriving insurance markets are mostly the same ones that had them before the ACA.