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Julie Arkison remembers what it was like to buy health insurance before the Affordable Care Act created standards for coverage. The policy she had was from the same insurer that covers her now, but it did not pay for doctor visits, except for a yearly checkup and gynecological exam. “I couldn’t even go to my regular doctor when was I sick,” said Ms. Arkison, 53, a self-employed horseback-riding teacher in Saline, Mich. (Abelson, 7/15)

Before the Affordable Care Act, insurance companies could offer any combination of benefits in most states and legally call them a health insurance policy. A huge deductible? Coverage for only one night of hospitalization? Nothing for maternity care, mental health or medication? (Bernstein and Cunningham, 7/15)

Julian Senn-Raemont isn't convinced he needs to buy health insurance when he loses coverage under his dad's plan in a couple of years — no matter what happens in the policy debate in Washington, or how cheap the plans are. The 24-year-old musician hasn't known a world without a health care safety net. But he hates being forced by law to get coverage, and doesn't think he needs it. (Johnson, 7/17)

The two leading health insurer trade groups sent a strongly-worded letter Friday expressing opposition to a controversial conservative provision included in the latest GOP ObamaCare replacement bill. America’s Health Insurance Plans and the Blue Cross Blue Shield Association warned that the provision from Sen. Ted Cruz (R-Texas) would mean “premiums will skyrocket for people with preexisting conditions” and “millions of more individuals will become uninsured.” (Sullivan, 7/14)

Insurers have worried that under the Cruz proposal, the health market would be split in two. Healthy and younger people would flock to cheaper, less comprehensive plans, while people with pre-existing conditions who need more comprehensive coverage could have to pay far more. That has alarmed centrist GOP senators who want to maintain protections for people with pre-existing conditions. And although conservatives sought the Cruz measure, its current version has left them divided because of a change in the way the market where people buy insurance when they don’t get coverage on the job would be structured. (Armour and Peterson, 7/14)

“The fundamental guarantee at the heart of the Affordable Care Act was that people who are sick can get insurance at the same price as everyone else,” said Larry Levitt, an insurance market expert at the nonprofit Kaiser Family Foundation. “The House and Senate replacement bills move the system back to a place where healthy and sick people are treated very differently.” (Levey, 7/16)

The latest Senate health proposal reins in costs by effectively splitting the individual insurance market, with healthy people diverted into stripped-down plans and chronically ill individuals left with pricey and potentially out-of-reach options, insurance analysts said. This draft — a fresh attempt by the Republican Party to undo the Affordable Care Act — injects more uncertainty into plans for people with preexisting conditions such as cancer, asthma, diabetes or other long-term ailments. Those people, insured through ACA marketplaces now, could be more isolated than in an earlier version of the Senate bill. (Hancock, 7/17)