 Free riders raise the costs of keeping the system ready for them, a cost that is paid by all who contribute to it by obtaining coverage in it. So the “real choice” of those who forego coverage (and become free riders) harms those who “choose” to pay for coverage each year. These harms to others are encouraged whenever such a choice is allowed. The replacement plans for the ACA in promoting such choices are premised on allowing these harms to third parties. The price of encouraging some people to forego coverage is to encourage free riding and the resulting harms to third parties.