The Republican Plan To Cover Sick People Might Sort Of Work, But Nobody Really Knows
WASHINGTON ― Republicans think they have a better way to organize the individual health insurance market and deal with people who are already sick: throwing them a sad pool party.
The health care bill Republicans passed in the House earlier this month would allow states to opt out of the protections that the Affordable Care Act, or “Obamacare,” established for people with pre-existing medical conditions, but only if they set up so-called “high-risk pools” instead. These pools would accept people who are considered “risky” to insurance companies because their health histories suggest their future medical claims will cost the companies a lot of money.
It’s not a new concept. High-risk pools have existed since the 1970s and were in operation in 35 states when the Affordable Care Act became law in 2010. They’ve never had a ton of funding, and only insured about 220,000 people when they were phased out ― which is far fewer than the estimated 25 million with pre-existing conditions and no insurance.
House Speaker Paul Ryan touted his state’s version as an example earlier this month. “In Wisconsin, we had a really successful high-risk pool,” said Ryan, adding that 10 percent of Wisconsinites on the individual insurance market bought plans from the pool, which was called the Wisconsin Health Insurance Risk Sharing Plan.
“They could go to any doctor or any hospital they wanted. And their premiums and co-pays were cheaper than they are under Obamacare today.”
The Wisconsin pool covered about 20,000 people each year before it folded as the Affordable Care Act’s subsidies and protections for individual health insurance consumers took effect in 2014. […]