So what's the problem? What's gotten the most attention are the significant rate hikes on those health exchanges. Some states like Arizona have gotten hit hard, but some states have not, and either way, most beneficiaries don't really feel the increases because they are covered by subsidies. Still, the chief problem appears to be simple economics — in some parts of the country enrollment has not been as high on the individual market as expected and those who have enrolled have been sicker than expected. A lack of competition has worsened the problem. Most experts predict that the markets should stabilize, nevertheless, but they'd probably improve considerably if more states signed on to the Medicaid expansion, if the federal government enforced the individual mandate, and better yet, if it increased the penalty for those who fail to buy insurance.