I don’t know the real answer, but will bet a small fortune (that I do not possess) that Trump hasn’t a clue and the vast majority of our elected officials don’t understand the complexity of our modern healthcare system.
One thing I DO know about insurance — it requires people who don’t need it at that moment to pay into a system to support those who do. It’s about sharing risks with a community so that those in need can receive help that they could never afford on their own.
The other thing I know about insurance is that it’s a business. As a business, we have determined in this country that it’s need for maximum profit outweighs all other considerations. Any loophole that can be exploited, any denial of coverage is viewed positively and that the business is staying true to its core reason for existing — maximizing shareholder returns.