The best part of the ACA is that patients could not be denied for existing conditions.  Previously, those patients with seriously expensive conditions were mostly paid through medicare and medicaid paid by the State and the Feds.  Under ACA the really expensive patients got their insurance.  The only difference is that the entire cost of their coverage is born by other ACA rate payers.  23,000 people, roughly 10% of insured people statewide, are paying the entire costs of our most expensive patients.  This is a good bill and should be a priority.