RWKAgency
Expert
You have some good points for sure. However, the only things you didn't mention that NY NJ and MA didn't have before were subsidies and increasing tax penalties. They still may have had a disproportionate amount of sicker vs healthy, older vs younger signed up with plans right now. I don't know how it will eventually play out, but I certainly hope I'm right even if takes a little longer.
Actually MA did have subsidies and it almost bankrupted the state in its first year. In the first year of the MA Individual Mandate, the state offered subsidies and what happened was the state saw unsustainable red ink and had to end it. The feds can't afford it either but they aren't afraid to run budget deficits.