Pre-existing conditions. I discussed this in a different thread long ago, but the long and short of it is that while I may qualify for a "car-crash emergency" type plan, it currently makes more financial sense for me to simply declare medical bankruptcy in case of emergency and pay small incidentals out of pocket than than pay a high premium/deductible on a plan that won't pay out unless I need tens/hundreds of thousands in care. Not to mention the risk of rescission. Meanwhile the COBRA payment from my last "real-job" employer was in the range of $400/month, which was not affordable for me.