| There's a triad of things that must be done together to make one of these "no preexisting conditions", cover everyone grand schemes work: Guaranteed issue are the words of art for not considering preexisting conditions. Community rating (https://en.wikipedia.org/wiki/Community_rating), means charging everyone the same amount, although that's often "Adjusted"; for Obamacare, by smoking, and maybe somewhat by age. Individual Mandate: everyone must be part of the system. It's the latter two that are politically difficult. Community rating means the healthy young ("young invincibles" is the current phrase) must pay a lot more to cover the less healthy older folk, also men must pay more to cover women. And it's not hidden in taxes like a single payer system. The mandate of course means you can't escape the game for the sorts of reasons you've noted. And it's political poison, e.g. presidential candidate Obama, unlike Hillary!, was against individual mandates. And as you've noted, it's relatively easy to zap and in due course kill the rest of such a system. Three guesses what's going to happen in 3 years when the mandate ramps up.... Ah, another critical line of attack: "BAILOUTS FOR INSURERS!!!", the "risk corridors" that will prevent them from going under this year, and the next one or two, due to insufficient signups and more importantly payments. "Official" enrollment figures for Healthcare.gov were those who've put a plan in their cart, as of a while ago not even those who then hit "sign me up", and the communications between it and insurers are horrible, and I doubt the government even knows who's "signed up" but never paid, or stopped paying, or didn't pay their first huge bill that started to satisfy the huge deductibles of lower grade plans. |
There will be attrition over the next several months, but I don't think it's accurate to say the official figures refer simply to people who "put a plan in their cart".