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Both of your proposed solutions are flawed.

First, health insurance for individuals should NOT depend on employment. The tax exemption for employer-paid health insurance should be terminated, and replaced by a “first dollar” exemption for individuals, without any deductible and in addition to the standard exemption. This should apply to 100% of insurance premiums, and to MSA allocations, but perhaps with a cap on this part. Also, individuals should be allowed to purchase such coverage through membership in associations of their own choosing, including religious, civic, community, and social groups.

Second, although every person must have access to insurance coverage - at any age, state of health, risk exposure, or present coverage - EACH of these conditions should be considered in setting the premium for INITIATING coverage. This is the way that Medicare “D” works - Once eligible, I MUST maintain “qualified” coverage, or I will pay a higher premium when I renew during the next enrollment period.

However, IF I have qualified coverage, I can change to a similar plan with a different insurance company during the annual enrollment period, at the same rating level. In other words, no denial of coverage or “pre-existing condition” rating. But note that if in the past I had a coverage lapse of 1 or more years, each uncovered year would increase my rating. And because age is a risk factor, I see no problem with premiums based on age - unless the initial contract specified “flat rate” AND continuous coverage was maintained.

The continuous coverage should begin at 18, OR at emancipation if the young person were covered until then by insurance provided by a parent or guardian.

For hardship circumstances, the insurance companies could provide an assigned risk pool for basic coverage, perhaps with support from government funding.

Thanks for the note. Although you use the word “flawed” I would say that the proposals are efforts to deal with an imperfect world. There are many things, including some of the things you mention, that I might do if my starting point was a blank sheet of paper.

But simply ripping up established social and economic arrangements across 20% of the economy and in a way that impacts almost every American is bound to have many unintended consequences even if it was politically viable.