What Health Insurance Risk Pooling Is, and Why It’s Key to Maintaining Affordability

Linda J. Blumberg and Justin Giovannelli | 2026-03-11This explainer describes how health insurance risk pooling works and explains how recent federal policy changes — including Medicaid cuts under H.R. 1, the expiration of enhanced ACA premium tax credits, reduced marketplace enrollment, and regulations lowering the value of coverage — will shrink insurance risk pools, raise premiums, and shift costs onto sicker Americans.Please click here to view the publication.