The ACA was a huge attempt to control health care costs as well as increase access to care under the auspices that mass enrollment of healthy people would in turn lower the risk pool and thereby costs. It didn't happen, but that was one of the goals. Also, it helps to remember that the ACA was supposed to be straight up single-payer healthcare at the outset. This resultant thing is just a weird compromise that pays off the insurance companies.

So if it was up to me, children would be covered until 18 at least with a CHIPS-type program. It's a moral obligation to take care of those who can't take care of themselves for me. That would still leave the market to develop solutions and provide other options (which I don't think will look similarly to what we do now; it's unsustainable).

The reason I want to look at the pre-existing conditions question is that the number seems really really high when they say that 15 million people will be losing healthcare. And so when I started digging I found out that the number largely includes a huge expansion of Medicare which right off the bat included an 'increase' of 11 million people as insured. They're not really insured in the common understanding of the word, so it's misleading to say that they'll lose insurance coverage. They're just restructuring the medicare program and they'll lose access to that.

All in all, measuring insurance coverage is a ridiculous starting point. I don't want people to be insured. I want them to get the healthcare they need. In a perfect world for me that comes from the free market, but health care is a strange economy because as kleinbl00 pointed out, there is a disinterested, always paid third party in the room that just keeps raising prices without regard to what it does to the customers on either side. I think that has a lot to do with how hard it is to become a health insurer due to regulation (i.e. I can't start a health insurance company to compete due to huge and multiple barriers to entry even on a small town-level scale).

You see a simliar, thought not exactly the same by any means, argument in the internet side of things. People bitch about internet costs, and Comcast says you can go fuck yourself because they know you can't buy it from anywhere else due to regulation. Then you say fine, I'll start my own ISP with blackjack and hookers. And you can't, because Comcast has regulated monopolistic access to the wiring needed. And you can't, because Comcast lobbies to keep it that way. So you end up in a high-cost no competition situation where it would make sense for your city to start up an ISP and run it as a state-owned entity, giving the same people who fucked you over by cozying up to Comcast control over your internet access.

I don't think the government is my friend. I think they are in the pockets of a lot of people. I think that if I can remove them from my life as much as possible it increases my liability and risk personally, but that is a cost I am willing to pay. So I don't want them in healthcare.