Puerto Rico is now the perfect place for people who think Obamacare is the worst thing since slavery, but would also like to be insured. Territories are now exempt from most of the requirements of Obamacare. Guam, the U.S. Virgin Islands, American Samoa and the Northern Mariana Islands have high uninsured rates, but Puerto Rico has a pretty good publicly funded health care system.
The Center for Medicaid and Medicare Services announced Wednesday that the five U.S. territories would mostly be exempt from Obamacare's requirements, according to Sarah Kliff at Vox. Like the 50 states, territories were required to offer insurance to everyone and use 80 percent of premiums on health care. Unlike the states, territories didn't have an individual mandate or subsidies to lure people into the exchanges. Obamacare's detractors were worried that young people would be turned off by high (but subsidized) premiums, and only old and sick people would sign up for the plans, driving premiums through the roof — aka a death spiral. Without a carrot (subsidies) and a stick (the mandate) to convince healthy people to enroll, that's what happened in the territories.