[LorenPechtel]

The problem here is that pre-ACA you didn't have insurance, either.

Yes, they would (maybe--some plans saw huge sticker shock because the original didn't actually pay much of anything) sell you "insurance". They would offer a plan for a few years, then close it, offer something new. The old plan would see patients getting sick, costs would rise. Premiums were based on costs *for that plan*. Soon the healthy jump ship for something else, now the old plan is only the sick and the premiums go into a death spiral.

Thus the reality was that any ongoing problem soon you were uninsured.