But an even more equitable solution would be to change the insurance premium basis from risk-based pricing to income-based pricing. Richer people should pay more for insurance not only because they can afford it but also because changing the premium basis from risk to income removes any option for denial of coverage based on pre-existing conditions.
Germany's healthcare system uses income-based premiums in a 3-tier model. In the first tier, a government plan provides basic coverage to the poor and unemployed. When you loose your job, you automatically drop into the government plan and your benefits are covered as part of your unemployment insurance. But the benefits offered in the basic government plan are really not desireable. In the second tier, private insurers compete in different industry markets using the government plan as a floor for coverage benefits. Premiums are based on income, and employers must match at least 50% of the premium cost, but many can and do offer more. The private insurers are all regulated in terms of their product offerings by the government and any medical practitioners or healthcare providers in the public system are available. In the last tier, Germany offers a fully private system in which premiums are based on risk (younger people pay less), and patients can only use private providers and hospitals.
The German system provides three levels of coverage - public, semi-private, private - with lots of competition, well regulated practices, and income based premiums for the 90% of the population. Its not a perfect system, as every system requires constant monitoring and dynamic steering. But it provides medical services far superious to the US system at far lower costs with social equity.
What I see in the current healthcare proposals in the Senate and House Bills are a hodge-podge of tactical solutions and a paucity of strategy. There are so many good healthcare systems that work throughout the world. Many use income-based premiums. Its a smart way to go.