I would like to get a catastrophic plan that doesn't cover things I would categorize as consequences of bad choices. I get that covering these things is less costly for society than just letting things run their course, but it does drive costs onto everyone else's premium.
Catastrophic plans are still quite costly because they aren't really a pure insurance product. Mine is over 2k/month for 3 people on an ACA Bronze plan with HSA.
The challenge with such carve-outs is it incentivises broadly defining the offending lifestyle choice. So the specifics matter, because otherwise, insufficient diet and exercise (or, for the exceptions, overexertion) is a lifestyle choice that can be positively linked to pretty much any issue for any person.
Even if everyone's fit and has a good diet, maternity care is medically important and starting a family in a free country** definitely counts as a lifestyle choice because some choose not to do it.
Human childbirth without any care has quite a high fatality rate*; no childbirth, no next generation to cover the pensions of today's taxpayers.
* I don't know if South Sudan had something weird going on to push their lifetime rate of fatal complications from maternity to 35% in the worst years, but even if they're an outlier there were plenty of other countries trending at around 10% in 1985: https://ourworldindata.org/grapher/lifetime-risk-of-maternal...
** Not so in places without women's reproductive rights.
Catastrophic plans are still quite costly because they aren't really a pure insurance product. Mine is over 2k/month for 3 people on an ACA Bronze plan with HSA.