I would just drop the pre-existing condition clause and maybe automate more of the record management to avoid unnecessary repeating of some expensive testing where it makes sense (ct scans etc).
Provided a company offers coverage, I think the ratio of healthy vs sick people in a company is maybe 80/20. If we can extrapolate this to the entire population , I dont see how healthcare is not affordable even for the unemployed individual ( pre-existing condition being dropped).
Also, some states offer high risk pools with affordable premiums ( max 400/month for PPO in network etc).
So I dont think the reform is needed but just some tweaks, especially the one about pre-existing conditions.