His description of the existing plan is not correct: He ignores all subsidies and Medicaid, and says everybody who signs up pays the same amount. That is so not true, it makes everything after that meaningless. He also ignores the fact that people who do sign up can choose their level of coverage and premiums, from Bronze to Gold. (And they DO, based on how sick they are.)
The main problem is that we let people off with a small penalty for not being insured and still take care of them when they show up at the ER. The fine is far, far less than even the cheapest Bronze ACA plan, (essentially a catastrophic care plan with about a $7000 maximum-out-of-pocket, $7000 deductible, and no upper limit).
If we are going to deliver this kind of cost to the non-participants anyway, then we ought to just charge them for it. Eliminate the tax penalty, require minimum participation in the government's run Bronze plan, and keep the subsidies and Medicaid for the poor.
Or the other option would be to eliminate the Mandate and let the uninsured die in the ER parking lot. Choose one, because our half-assed compromise is driving companies out of the insurance business and driving hospital costs up for the rest of us to cover their expenses of the uninsured.
