Because I'm too sick for my insurance to cover all my meds and not sick enough to be eligible for the exchange.
Any sentence that involves "too sick" or "not sick enough" is not relevant to this discussion unless it also includes the words "no longer relevant to your coverage".
The only people who are not elgible for the exchange are
1) undocumented aliens
2) prisoners
3) unicorns
and your health never enters into the equation AT ALL; the entire point of the exchanges is to make the process as blind and "negotiation"-free as possible. Once you are on a plan, the only reason an insurer may drop you is non-payment (remember the poor are subsidized) and the only factors that may adjust your premiums are:
1) age (the elderly may be charged up to 3 times as much as the young, which is substantially less than today for private insurance)
2) geographic area (I understand the rationale here but am critical nonetheless)
3) whether you are a smoker (though you can only be charged 1.5x as much, in a staggering victory for [strike]Big Tobacco[/strike] me)
and
4) the size of your household (which is totally fair I think and offset by the fact that the size of your household determines where your income falls relative to the poverty line, which dictates your % costs)
Though fulltime employees of large (50+ FT employees) employers offering health care with at least 60% cost coverage and a premium cap of 9.5% of your annual income (a great deal of which will be subsidized for you by the government if you make less than 400% of the poverty line) who REFUSE that coverage are not elgible for government subsidies when purchasing insurance through the exchanges.
In general, our HC system now more-closely resembles the Japanese system than any other.
If I am wrong about this feel free to correct me.