Trump is on record supporting preexisting coverage and kids till 26. Once you do that you have a mess on your hands which can’t be completely conservative. Therefore they can’t just repeal it, or let’s say they are not going to. So we need to get as much free market reform as we can.
Trump’s statements on pre-existing and coverage of children/adults to age 26 can be parsed to mean: “there should be policies that people can choose that will allow coverage of young adults under their parents”. That is completely c/w a free market, if there is the demand there will be a product and young adults have traditionally been covered by college plans for a couple $100/year so the plans would not be much more expensive.
The pre-existing piece does not need to be a deal breaker either. If States have policies for what can be sold in their states it can be handled as a requirement that patients to be dropped for serious illness have a 3 year period to find other insurance and the policy can only go up X amount/yr.
The States can have exchanges for people who are unable to find policies and work out the rules/subsidies etc that they think work best in their state.
I do not believe insurance companies can be told who they have to cover. Insurance is an actuarial product and if there is a known outcome/cost for a particular individual it is no longer insurance its “who pays.” So there can be rules made about continuing coverage when someone has become seriously ill but forcing a new insurance agency to take on someone who is ill is unreasonable. That is why the State would have to set up a saftey net for people who are uninsurable.
90% of the problems with ACA stems from the pre-existing coverage provision. So anyone who wants to keep that wants ACA, they just want tpo make a few cosmetic changes. They also don't understand how insurance works. Before ACA there was chairy care, but it wasn't considered insurance, because that is not how insurance works. Basically, you are saying you want a system that punishes the healthy and leaves them without coverage.