Hard to believe a congressman said NOBODY DIES BECAUSE THEY DON’T HAVE ACCESS TO HEALTH CARE

…according to Iowa Republican Congressman Raúl R. Labrador. *

But New York Democratic Congressman Sean Patrick Maloney got it right when he said “Any member of congress who voted for the bill should be obligated to join a high risk pool.” ** 

HIGH RISK HEALTH INSURANCE POOLS in Trump/ Ryan Care carve out individuals with pre-existing conditions but does not guarantee them access to affordable health care.

This is under-the-radar but that’s why we need to be vigilant. So here’s a nerdy HIGH RISK 101.

The House Trump/ Ryan Care bill… would allow states to apply for waivers for certain ObamaCare provisions, such as a ban on insurers charging premiums based on a customer’s health and the requirement that insurers’ basic health plans cover certain services, like prescription drugs and mental health. 

How do we know this was a dodge?

An under-the-radar GOP amendment would have exempted members of Congress and their staffs to ensure that they will still be protected by those ObamaCare provisions. It was deleted after it was discovered. (A) When Congress tries to exempt itself, we know its shenanigans!

High-risk pools are private, self-funded health insurance plans organized by state to serve high-risk individuals who meet enrollment criteria and do not have access to group insurance. (B)

“High-risk pools are a key concept that helped House Republicans pass their replacement for the Affordable Care Act. That bill, the American Health Care Act…allows states to opt out of the requirement for insurers to cover people with preexisting conditions and set up high-risk pools for these people instead. A late amendment to the bill added $8 billion* in additional funding over five years for these potential pools, and that change garnered enough new Republican votes for AHCA to pass the House.” (C)

 “In a nutshell, high-risk pools: are prohibitively expensive to administer, are prohibitively expensive for consumers to purchase, and offer much less than optimal coverage, often with annual and lifetime limits, coverage gaps, and very high premiums and deductibles.” (D)

There have been state high-risk pools for 35 years, prior to the ACA. A recent Kaiser Health Foundation report on the state programs noted: “These high-risk pools likely covered just a fraction of the number of people with pre-existing conditions who lacked insurance, due in part to design features that limited enrollment. State pools typically excluded coverage of services associated with pre-existing conditions for a period of time and charged premiums substantially in excess of what a typical person would pay in the non-group market.” (E)

“…unless high risk pools are adequately subsidized, high premium costs will mean all high need consumers will not be able to afford coverage. State policymakers will need to address those implications as more consumers may face personal bankruptcies and unmet needs, and as states witness an increase in the number of uninsured and more demand for uncompensated care.” (F)

“The history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class health care coverage — if they are able to obtain coverage at all.” (G)

WHAT OTHER DAMAGE TO ACCESS IS BURIED IN THE BILL THAT HOUSE MEMBERS DIDN’T READ BEFORE THEY VOTED FOR IT?  

 

 * https://www.washingtonpost.com/news/powerpost/wp/2017/05/06/nobody-dies-because-they-dont-have-access-to-health-care-gop-lawmaker-says-he-got-booed/?utm_term=.93a5e7087576

 ** WAMC public radio

 

(A)   House GOP health bill changes exempt members of Congress by Peter Sullivan, The Hill, http://thehill.com/policy/healthcare/330592-house-gop-health-bill-changes-exempt-members-of-congress

(B)    CONSUMER GUIDE TO HIGH-RISK HEALTH INSURANCE POOLS, NAHU,  http://www.nahu.org/consumer/hrpguide.cfm

(C)   Sounds Like A Good Idea? High-Risk Pools, by Julie Rovner and Francis Ying, KHN, http://khn.org/news/sounds-like-a-good-idea-high-risk-pools/

(D)   Why High Risk Pools (Still) Won’t Work, by  Jean P. Hall, Commonwealth Fund, http://www.commonwealthfund.org/publications/blog/2015/feb/why-high-risk-pools-still-will-not-work

(E)    High-Risk Pools For Uninsurable Individuals, by Karen Pollitz,   http://kff.org/health-reform/issue-brief/high-risk-pools-for-uninsurable-individuals/

(F)    High Risk Pools Deja Vu – Lessons from States, Questions for Policymakers, by Trish Riley and Anita Cardwell, NASHP,  http://www.nashp.org/high-risk-pools-deja-vu-lessons-from-states-questions-for-policymakers/

(G)  High-risk pools won’t match Obamacare’s protections for pre-existing conditions by Tami Luhby, CNN, http://money.cnn.com/2017/05/03/news/economy/high-risk-pools-obamacare-pre-existing

 

 

 

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