Here's an article, that was written by a conservative, which makes some sense, tho I still disagree with the author, Jennifer Rubin's, main premise. Ultimately, I think she feels that the taxpayers should not subsidize health insurance for the most part. Republicans, that are more thoughtful than Trump, do have some ideas about healthcare reform, that this author talks about, but I get lost in the weeds (so to speak) by their complex plans that are based on private enterprise. I actually don't think private enterprise can cover the large number of folks who are both low income and have high healthcare costs. I still think it would take a subsidy, from (most likely) taxes, to do the job. That should be what taxes are for.
The health insurance market, for individuals that are not covered by employer plans, has been messed up for decades. It's that troubled market for people who aren't able to have their insurance provided by group plans; such as employer plans. The Obamacare reforms have tried to fix this problem, but haven't worked as well as they could, ideally. The problems still persist, tho they are not as bad as they were before. For most people, the subsidies and Medicaid expansion, of Obamacare, cushions the blow. Better than in years past.
Folks with higher incomes, that aren't eligible for the subsidies or Medicaid and aren't on employer plans, are feeling the pinch, however.
The individual markets have been a struggle for years due to the economics of health insurance. Plans refusing to cover folks with preexisting conditions, spiraling premiums, companies withdrawing from the market; since the 1980s at least. Obamacare has tried to fix this, but has had its struggles as well.
I would guess that the problem is worse in states that refuse Medicaid expansion. That situation throws the whole thing out of kilter even more.
Seems like the problems were worse before the Obama reforms. Problems caused by the wide income gap in USA, the poor health of much of USA's population and the fact that large numbers of people have not been covered by our system that is based on employer provided plans.
Basing healthcare on employment status is a mistake that goes way back to the 1940s. I would guess the employer insurance system, we have in USA, should have never gotten started in the first place. Since lots of employers don't provide plans, that system has always been full of holes. Worse as time goes on.