Since insurance companies cannot reject pre-existing conditions, their risk (and with that, the premiums) has gone up significantly. Now the young, healthy people can’t afford the high premiums and would rather pay the IRS penalty. The people signing up are often the people who need the insurance and couldn’t obtain it before, due to pre-existing conditions. The cost to cover those people are much higher, since their premiums will never cover the cost to the insurance company. Insurance raises rates, more young people drop out and the death-spiral continues. It is another unsustainable situation.
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