JUST DON’T CALL IT A DEATH SPIRAL: Inside the Affordable Care Act’s Arizona Meltdown.

A look at what happened in Arizona shows problems with the design and implementation of the ACA, combined with early missteps by insurers. Some priced plans aggressively, angling for market share and betting special programs built into the law would protect them from losses. Those protections didn’t work as expected. Enrollees’ health-care expenses repeatedly overshot the projections of nearly all Arizona’s insurers. The result: a flood of red ink, then withdrawals and premium increases.

“The Arizona market is the poster child for the problems the exchanges are experiencing nationally,” says Tom Snook, a Phoenix-based actuary for consultants Milliman Inc.

Can individuals be mandated to buy a product no one is selling?