Sometimes these things do not appear to have been fully thought through.
Mandates and requirements carry their own price. Including an extraordinary number of these ornaments may only be paid for at one place - the consumer level. No matter how much anyone may hate and despise the commercial aspect of insurance pools, the fact remains that they must - MUST - never operate at a deficit, else they are soon cannibalized and no longer exist.
It matters not if the person covered by the policy is making the direct payment into the insurance pool, or if another is paying on behalf of the person covered. This is absolutely the wrong place to practice stringent thrift.
“Sometimes these things do not appear to have been fully thought through.”