Agreed.
I think the answer, sadly, is for the high risk/cost to be forced to the Medicaid situation if they aren’t covered by insurance. Same deal, basically, as happens to the elderly.
Either keep yourself covered when you need it, find a way to pay for it othewise—or become essentially a ward of the state.
To me that is the obvious answer, but I doubt the one the pols would go for.
It’s a better answer than forcing us all to become wards of state, and isn’t that what Obamacare has done to anyone who doesn’t have an employer-provided policy or got coverage outside the exchange? Even these are bearing some of the brunt of the cost, all policies have to be compliant whether bought on the exchange or outside of it.
My solution is simpler: (1) allow anyone, no matter what their medical condition, to purchase inexpensive catastrophic insurance, which covers nothing except disaster: falling off a ladder, cancer, getting hit by a falling tree, etc. That is not possible under the ACA, nor was it possible just prior to the ACA, although it was possible many years ago.
Also, (2) all small businesses should be allowed to group together to form their own pools, thereby spreading risk, enabling them to offer group insurance. If that were the case, almost everybody would have access to insurance. Normally people with group insurance are not scrutinized too closely for pre-existing conditions.