Why replace it? Repeal it, and the laws hindering buying insurance on the free-market from wherever you wish. Then let it work itself out. I'm torn on pre-existing conditions, too. I don't like companies that drop people who purchase and use their product, thus forcing the move to a new policy with an existing condition, but I look at pre-existing conditions as someone buying homeowners' insurance after the house burned down, then forcing the insurance company to pay for the damage.
There has to be some middle-ground. Maybe split it, if you had coverage and were dropped, there could be recourse, but if you had no prior coverage, then too bad....
This is the United States of America, not Empire USA.
Rand Paul has the best idea I’ve heard. Health insurance analogous to whole life insurance. At age 18 or 22, people should be able to purchase 40-50 year health insurance plans.
This solves most of the problems with pre-existing conditions.
The coverage would be true catastrophic insurance, so premiums would be reasonably priced.
The difference could be paid in a number of ways, from out of pocket to supplemental insurance.
Writing these policies would be enormously complex, but that’s what actuaries and medical experts are for.
And plans could be rated by independent PRIVATE accrediting agencies to facilitate informed shopping.
After age 72 people could be covered by charity or Medicare.