The reason insurance rates have gone up, is because the ACA made it illegal for someone to be refused insurance coverage because of a preexisting condition. Those people cost insurance companies more than heathy people, but the expensive customers were previously excluded from the insurance pools this keeping costs down. The hope was that enough younger healthy people would sign up for fear of being taxed that it would balance out the insurance pools and costs would then not increase. But young health people realized two things, insurance premiums were higher than the tax and that they could wait until they got sick before signing up for insurance because now they couldn't be excluded anymore.
Stupid system from the get go. Should have gone with single payer. But, the main point is, preexsiting conditions are baked into the system already, they are already the reason your premiums are high. The only real choice for the Pubs is to say fuck you to preexisitng condition people and repeal Obamacare but that would screw over a lot of voters, roll those people into Medicaid or Medicare somehow and absorb the cost at a federal level but that would screw over the rest of us tax payers, or move the whole system to a single payer plan but that would screw over the insurance industry. I think Obama played the long game here. I think he knew the ACA was flawed an would not work but that once it was in place the Pubs would have only bad or expensive choices for getting rid of it or replacing it.
