While President-elect Donald Trump may be offering a compromise on the Affordable Care Act (ACA) by keeping its ban on insurers denying coverage based on preexisting conditions, it’s doomed to fail if insurers can charge sick people more.

That’s according to Jonathan Gruber, PhD, a health economist at the Massachusetts Institute of Technology who helped the craft the ACA. Writing in the New York Times, Gruber said the pre-ACA insurance market, the primary source of profit was denying coverage to sick individuals. If insurers are allowed to charge much higher prices to people with pre-existing conditions, the coverage requirement won’t help.

“The insurer could offer coverage, but say that any breast-cancer survivor had to pay, say, five times more than everyone else. Both would be perfectly legal if the Affordable Care Act was repealed and replaced under Mr. Trump’s principles,” Gruber wrote. “If we say that insurers have to pay for breast-cancer treatment for their insured but allow them to set unaffordable prices or deny insurance altogether, how does that solve the problem?”

For more on why Gruber thinks any ACA replacement plan will come with serious financial risk, click on the link below: