Kevin Williamson makes the case that a lot of people made for the individual mandate or something like it: If you’re going to forbid insurers from discriminating on the basis of health status, then you have to make people buy health insurance. Otherwise, they’ll go without it until they get sick and then buy insurance knowing they can’t be charged more than anyone else. If enough people game the system this way, premiums will rise, some healthy people will stop buying insurance, premiums will rise further, and so until the system has unraveled.
But we’ve now had a couple of years with the pre-existing ban and without the individual mandate, and it doesn’t look like the sky is falling. If more healthy people got insurance, premiums could come down a bit — but we could make gains on that front without the coercion of bringing back the mandate or Buttigieg’s new version of it. (A version that may be unconstitutional.) When it is not necessary to coerce, it is necessary not to.