Why Is Health Insurance So Expensive In New York? 
This question was asked before implementation of the Affordable Care Act , but the answer highlights important features of the new law : coverage for preexisting conditions , and the mandate to purchase . Health insurance in NY was expensive because laws required insurers to issue policies regardless of health . Healthy people were not required to purchase a policy . Eventually only the sickest people enrolled in the plans , forcing premiums very high . The Affordable Care Act includes a mandate for health people to purchase coverage . It remains to be seen if the penalty for being uninsured is stiff enough to avoid what happened in NY . 