Fixing the demographics is pretty easy. Kill the group market.
Of course easy is different than politically feasible.
Of course easy is different than politically feasible.
Killing the group market could create certain efficiencies, but it would lose many others. And like you said, that is politically infeasible.
Other options, like looking at cross-state competition and capping certain medical expenses are likely better possibilities.
I expect the only impact of cross state competition would be a race to shitty insurance in the state with the worst regulation.