Tom Price, Trump’s pick for Health and Human Services (HHS) secretary, proposed a health care plan that included the creation of high-risk pools. The plan was called the Empowering Patients First Act of 2015.
High-risks pools are designed to provide people with preexisting conditions another health care option. The plan provides individuals with tax credits to help pay for medical coverage.
The problem with the Price plan is it forbids insurance companies from rejecting patients with preexisting conditions with a caveat. You cannot be denied health insurance if you have preexisting conditions IF you maintain coverage from 18 months. If you get a new plan before being on a plan for 18 months you can be denied coverage for that condition for up to 18 months . So, if you have breast cancer and choose a new plan after being with an insurance company for 10 months you can be denied coverage.
OK, it’s pretty obvious his preexisting condition caveat is bad, but what about risk pools in general. Do high-risks pools work? The answer is, ‘No.’
According to the Kaiser Family Foundation, high-risk pools were tried in 34 states. Coverage costs are between 125 and 200 percent of the standard market rate and from 2002-2010 monthly premiums increased by at least 50 percent in 15 states.
The deductibles in high-risk pools are very high . In 25 programs the deductible was $1,000 or higher.
Patients have to endure long wait times for care in high-risk pools. People literally died while they were on the waiting list. Richard Figueroa was one of the original staff members of California’s Major Risk Medical Insurance Program (MRMIP) when it started in the early 1990s. He said thousands of people were on the waiting list for coverage only to find that they couldn’t afford the premiums.
High-risk pools often have strict limitations. California’s plans have a $75,000 annual health claim payout and a $750,000 lifetime maximum payout. People with hemophilia often exceed the lifetime maximum payouts.
To be clear, high-risk pools often involves long waits to receive coverage, high prices, limited benefits, limited choices, and death.
Needless to say, this is not a good healthcare solution. This is yet another horrible idea offered by Republicans.
Both parties are bankrupt, but I don’t see them as irredeemable.