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When governments force private health insurance companies to issue coverage to people with preexisting conditions and charge them the same rates as people who have been paying premiums for years, who pays for the added costs?

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Per a 2005 textbook by Jonathan Gruber, an MIT professor who helped craft Obamacare, such mandates "involve redistribution from the healthy to the sick" and require that consumers pay more than they otherwise would. These policies are similar to excise taxes in that they increase the costs of products and are borne by consumers. A 2016 report by Blue Cross Blue Shield found that in the wake of the Obamacare mandate on preexisting conditions, newly insured people "used more medical services across all sites of care, including inpatient hospital admissions, outpatient visits, medical professional services, prescriptions filled and emergency room visits."

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