Maybe it is wrong to ask insurances to insure people with pre-existing conditions. Perhaps such cases should be considered charity or social help, and convered by the state? Just wondering if reframing the problem as such could help. I'm not from the US, so not sure what exactly the issues are.

It seems healthcare.gov is not good enough yet? I don't think classifying government institutions as startups is really correct, though. They have infinite money supply and no requirement to be profitable.