High-Risk Pools Are Not a Feasible Alternative to the Affordable Care Act’s Pre-Existing Conditions Protection

A young patient who uses a special program funded by the Affordable Care Act embraces his medical specialist, on December 16, 2016. AP/Charles Krupa

Washington, D.C. —(ENEWSPF)–February 16, 2017.  As the Center for Medicare and Medicaid Services under the Trump administration rolls out rules designed solely to benefit the insurance industry at the expense of health care consumers, the Center for American Progress has released an issue brief looking at the perennial conservative proposal for covering patients with pre-existing conditions: high-risk pools.

Instead of developing a market that is accessible and affordable for everyone, a high-risk pools approach would simply quarantine less healthy people in separate markets. Furthermore, high-risk pools have consistently failed in the past.

“High-risk pools are not a serious alternative to replacing key provisions of the Affordable Care Act,” said Thomas Huelskoetter, Health Policy Analyst at CAP and author of the brief. “They have consistently failed and proven financially unsustainable in the past. Furthermore, previous state high-risk pools generally featured significant restrictions on coverage that made it harder and more expensive for enrollees to access care. In addition, the proposals put forth by congressional leaders would be woefully underfunded. Quarantining sick people into a separate marketplace is the wrong approach.”

Banning discrimination on the basis of pre-existing conditions is one of the ACA’s most popular provisions and one that congressional leaders would be loathe to eliminate outright. Yet, rather than fully retain the ACA’s pre-existing conditions protection, congressional leaders often propose limiting it to people who are able to maintain continuous coverage for a certain period of time, while establishing high-risk pools for people who cannot maintain continuous coverage or otherwise cannot afford premiums.

Click here to read the brief.

Source: http://americanprogress.org

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