A perfect scenario in protecting people with "pre-existing" conditions would allow insurers to write those policies and take on that risk by designing plans to spread that risk out over their policyholder's portfolios. Much the same way it is done now.
However the difference would be allowing competition for price structure and coverage benefits, then allowing those insurers competing for those high risk dollars to offset their risk and costs and losses (since these are high risk insureds) through tax abatements or reductions.
For instance, let's say a health insurer decides to write 35% of its coverage portfolio into high risk pools. Let's say they also form a consortium with other insurers to spread that risk across several pools. Then, they compete against other insurers or risk pools for that business and for those premium dollars.
When they file their corporate tax returns, they would get either a percentage reduction in the taxes they would otherwise owe for accepting that risk, or essentially write off a portion of their tax bill or eliminate it if their risk portfolios exceed 50% of their income.
Any earnings they manage to secure by either spreading their risk, or developing more cost effective procedures to lower their costs insuring sick high risk patients would accrue to their benefit. But they would get the tax advantages of offering affordable high risk policies to folks with pre existing conditions, and by removing those folks from the general risk pool they would be able to offer lower cost policies to non pre-existing policyholders and be able to sell more of them profitably.
People who complain about facing higher costs because of existing illnesses would have low cost options available from specific insurers who would be willing to accept those risks, manage them, and turn them into profitable operations by spreading the risk pools and having their potential costs offset by lower or reduced taxes which improves their bottom line earnings statements.
They would save the Government (taxpayers) policyholders (premium payers) and the market which would not be distorted by high costs being absorbed by the non sick to cover the chronically sick.
Those folks would be in a risk pool specifically designed and managed to treat those high risk cases, and tax incentives are the reward to the company or companies willing to accept that risk.
The Left would still complain about Insurance companies not paying their "fare share" of taxes, but if they are willing to accept the risk of insuring and caring for folks with pre-exisiting conditions and can find a way to do so profitably, the tax savings should accrue to both them and the taxpayers who would otherwise be paying to treat those folks under much more expensive circumstances.
