> ... so that a health insurer can refuse to cover you on the basis that it might not be profitable for them. Or rather, on the basis that known expenses are n

> ... so that a health insurer can refuse to cover you on the basis that it might not be profitable for them. Or rather, on the basis that known expenses are not something which ought to be paid for through insurance. Which is completely correct: Insurance exists to mitigate risk. Once something becomes a pre-existing condition it is no longer a risk. The problem with the pre-ACA system was not that insurers sometimes wouldn't cover pre-existing conditions, but rather that the insurance you had at the time the risk was realized (when the condition was discovered) didn't cover the full lifetime cost of treatment for that condition—it was dependent on maintaining the same insurance plan. That implies that the insurer, and perhaps even your employer, has every incentive to drive you off your current plan once your condition is discovered and thus make your treatment someone else's problem. Whether we're talking about a broken bone or discovering that you have leukemia, once it's been established that the condition is covered by your insurance plan the cost of treatment should continue to be paid by that insurance provider—perhaps via a trust—even after you've switched insurance companies or dropped health insurance altogether. Having the payments for your treatment pass to the new insurer when you switch insurance providers is a unearned windfall for the original provider and an unfair (and ultimately unsustainable) penalty for the new insurer forced to take over treatment of your pre-existing condition.