The big difference is putting choice and price-based decisions in the hands of the consumer. That’s the first step in any sane cost reducing, free market solution.
A distinction apparently lost in this analysis.
... except for "the sick", i.e. pre-existing conditions, except for "the old" and except for "the poor". Their premium support will still be determined by the government. You can expect that millions will then vie to be treated as poor, old or sick. I fail to see the cost-reduction incentive.