Before the Affordable Care Act came along, 80% of Americans had quality health insurance, like my wife and I, through their employer or through government programs like Medicare or Medicaid. For some, this insurance was far from ideal, as it featured high costs and a limited choice of providers. But overall, this was substantive coverage which enrollees were by and large satisfied. On the other hand, the other 20% of Americans were either uninsured or faced the prospect of buying insurance in the unstable and discriminatory non-group insurance market. This is a market where it was totally legal for insurers to discriminate against the sick for any reason. Insurers could deny the sick coverage; they could charge them much more than the healthy for insurance or they could exclude their pre-existing illnesses from coverage. As a result, if you were healthy, you could get health insurance. This defeats the whole notion of health insurance. Health insurance is supposed to protect you against financial risk, not protect your insurance company against the sick. And as a result, people in this market were just one bad gene or one bad accident away from bankruptcy.