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Are high-risk insurance pools the answer?

Party of small government proposes big-government alternative to health reform's individual mandate

We definitely appreciate the idea of high-risk insurance pools. We’ve been promoting the state pools for years, in fact, as a last resort for millions of Americans with pre-existing conditions who can’t get health insurance coverage anywhere else.

But while we appreciate the idea of high-risk insurance pools, we know there are problems with implementation (due largely to funding issues). Risk pool coverage has varied from state to state, premiums have still been typically higher than standard premiums, and while demand is high, the supply of risk pool coverage has been inadequate. (In some states, enrollment is closed; in other states, no high-risk pool is offered.)

In other words, the program has needed work. And guess what? The high-risk pools delivered as part of health reform also need work. The pools are costing more but enrolling fewer than expected – and premiums are still expensive. People who desperately need the coverage are still waiting.

That’s why – like Forbes’ Rick Ungar – we’re interested to see Republican support for government-supported risk pools as an alternative to health reform’s individual mandate provision.

Now, as they seek repeal of the individual mandate, some Republicans are promising that adequate government funding will make the problematic high-risk pools a viable long-term answer to pre-existing conditions. But a huge question is, can they really make that funding happen (if they really are serious)? Ungar doubts it:

“I, for one, am extremely dubious about the likelihood that this approach would work any better in the future than it has in the past because it is hard to believe that Congress will provide the necessary funding to make it work. I could be wrong, but history has a funny way of providing a road map for what can be expected in the future.”

And we’re not certain they are serious. More likely, we think, Republicans are simply looking for any decent-sounding option to the individual mandate. After all, as Ungar points out, if the GOP had to choose between the two options for providing coverage to those with pre-existing conditions, the individual mandate is “the only one that would leave insurance coverage in the hands of the private market.”

So much for the free market, apparently.

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