What experts believe will happen under Trump’s plan is that healthier people will buy much cheaper plans that are not ACA-compliant. In order to be on the ACA marketplace, insurance plans must cover things like maternal care and pre-existing conditions. With less comprehensive coverage, healthier people will pay less month to month, but could face exorbitant medical bills if their health worsens.
When the healthiest people leave, the people still in the ACA marketplace will be sicker on average and need more care, meaning providers will increase premiums. Eventually, even some people who need more robust coverage will be unable to afford the higher premiums, dropping their ACA coverage and leaving only the very sickest. This cycle will continue until the remaining people in the pool are so sick, no insurer is willing to offer them coverage.
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