If your car gets vandalized, it’s not your fault, but your insurance company may suspect you’re parking in a neighborhood prone to crime. You thus might see your premium rise upon renewal. The same logic applies to home insurance. Undoubtedly, this can mean that people in lower-income neighborhoods face relatively higher risk premiums than those in posh suburbs. Life insurance applications ask dozens of questions designed to assess how great a risk you pose. This means a missionary who travels to poor countries to help the destitute is likely to be identified as a risk taker and pay a penalty for living a life of good works. It’s not existentially fair, perhaps, but it’s not discrimination based on malice either.
The reference also has a description of how the private markets are handling the pre-existing condition problem, and how government could help without taking over and destroying the health care system.