Because the republican politicians think one way, and their constituents have started feeling the other way.
Trump- "Who knew that healthcare would be so complicated?"
Everybody except Trump knew that, actually.
Paul Ryan- "The whole thing with Obamacare is that the people in the blue pay for the people in the red. The people who are healthy pay for the people who are sick."
This idea seems to be one of his problems with Obamacare, but as someone so astutely pointed out, 'you just described how insurance works.'
When you give people the option to back out completely from paying anything, then you greatly increase the cost burden of people who want or need the coverage. Which basically means they all have to pay more for it because there isn't that same store of funds. It's very simple math, so let's do a simplified example. If 100 people pay $2 each and it costs $20 to care for a sick person, those 100 people can pay for 10 of them to be sick and get proper care. If suddenly there are say, 50 people in the pool, they can only pay for half as many sick people. But you know what, it's still gonna be the same 10 getting sick, cuz it's the healthy ones who left because they didn't want to pay. The sick people are still there because they need the care and have pre-existing conditions and there will be a some healthy people still around because they're worried about accidents and diseases that can show up in the unforeseeable future (and that's the point of insurance, right? that just in case?). But everybody left is gonna have to pay 4$, or double what they did originally. And not everyone can afford that, so they drop out, and prices have to be increased further as the pool of money shrinks. The sick are left on the wayside because they might not be able to afford it with the limitations their individual conditions place on them. All too soon the money for adequate care is gone and the system goes defunct.
That's why the Individual Mandate is absolutely essential and not some liberal lawmaker's whimsy or afterthought. With the penalty, you pay less than you would if you bought into the coverage, but your still contributing something. We will all have to pay some to make it work or it won't work at all. You'll just have to think of it as a tax, because that's basically what it all amounts to. This is the perfect time to point to Canada, cuz that's how they have it. That does go hand in hand with paying a bit more, but it seems reasonable to me. And I wouldn't be surprised if they also have laws that directly regulate medicine costs. Erick is right in saying that a major part of the problem is that our healthcare is based on profit. This part of the economy is far too 'free' and cutthroat. You have big pharmacy and hospitals and specialists who charge a shitton because they can and get away with it (I have my own ideas of how I might handle it if I had the opportunity...). They go for max profit over a tempered profit and wider benefit. Personally, I want government regulations and restrictions in these kinds of matters but I know Republicans and other conservatives hate government interference. They also hate the taxes that (for example) maintains the highways and freeways that allow their businesses to stretch and supply to everyone across the nation and beyond instead of being constrained to their little niche in the dirt. They hate the 1960's laws on emission and pollution, that changed things that you can actually see the mountains from a backyard in LA, instead of the gray fog that blankets China and is literally causing thousands of people to be stricken with disease and sickness now. People who now can't work and require the time and attention of a caregiver. Clearly, not good for business owners and the economy... but I digress.
When you have big businesses creating monopolies and taking unfair advantage of people, who else but the government can step in and make necessary changes?
I would compare our country to a biological organism, and republicans are like the cells in a tissue that likes to whine and complain when blood is shunted to other tissues and organs that get damaged or sick. They're germophobes, afraid of all bacteria as foreign invaders while not realizing that for every human cell in our body, there are 10 that are not. It can be complicated and there are controls (as it is with immigration), but there is still cooperation and symbiosis. Even the dreaded E. coli is naturally found in our body and helps us with digestion. It's true, in the wrong areas or concentrations in our body, these other organisms within can cause damage, disease, and/or death, but to make no distinction at all and attempt to forcefully remove them all at once is a grave folly. A grave folly that all too many Trump supporters embrace. And no matter how important the heart is, if it hogs up all the blood and refuses to let enough trickle down to the rest of the body, the heart will suffer for it. (How many metaphors and references have I scrunched in to this, I wonder?)
It's not that republicans or conservatives don't care about other people. It's just that the circle of people they care for is much, much smaller. As someone who has been to the middle east and spoken to people and got to get a feel for attitudes and opinions... republicans and conservatives are so very similar to these all the different tribal, Muslim groups that some of them seem to hate that it's ridiculous. I'd go into it more but I think that's enough rambling for now.
Quite frankly, I'm glad this AHCA didn't pass (that's another big L for Trump, no matter how he tries to dodge it with semantics, just a transparent attempt to save face). It wouldn't have worked because like most republican calls for tax cuts, it isn't financially sound or stable in any meaningful way. And as with taxes, the numbers for costs and penalties should be reassessed and changed to meet the needs and requirements that different times and situations require.
Edit: You do realize that the creation and adoption of the insurance system in our free market is the major reason WHY healthcare is so costly in the first place? It's because our beloved free marketeers recognized and took advantage of an insurance company's ability to pay much larger quantities of money in exchange for health service than any single average person (and are contractually obligated to do so in the terms of the contract). Between medical service providers amping up the cost for care and insurance providers using this as both proof and excuse that everybody needs health insurance, the average person gets boned. Now they have to pay higher and higher insurance rates for less coverage (another way the insurers combat payouts to medical providers). It's a terrible cycle and system, and I think that's why Erick and I agree that the problem with health care is that it is run for profit.
Edit 2: And I just want to make it clear why certain people don't like that the AHCA still held onto the facet of not allowing companies to reject people for having pre-existing conditions. And they're mainly insurers. What it means, as it is hinted above, is that insurance companies are compelled to pay out. Before, an insurer could look at someone who has a condition that needs chronic care (med prescriptions, etc) and refuse to offer them insurance because they knew they would have to pay for that stuff and it would eat into their profits from that person, or even go beyond that if the condition was severe and/or the medicine is that expensive. The way insurance works is that they want to insure the young, the health, the strong, the ones who take care of themselves and don't take risks. That way, they only pay for the rare freak accident or disease, and the cost is absorbed by the other people they insure. If they can't say no, this is a problem. But again, this is a problem because healthcare is for profit and not a social service paid for by taxes.