Here's a new report from the CMS actuary, Richard Foster, who said that the high-risk insurance pool, meant as a stopgap for people with pre-existing conditions before the ban on pre-existing conditions fully kick in by 2014, will run out of money by 2011.
It was already clear that, under the Senate bill, insurers would not be prohibited from using your health status against you until 2014. In the meantime, they could continue to deny you coverage or charge you higher premiums. Now comes word that a program the Senate would create to provide relief until 2014 could run out of money as early as 2011.
That's the assessment of Richard S. Foster, chief actuary at the Centers for Medicare & Medicaid Services, in a Dec. 10 report. The White House disagrees, but if Foster's analysis is correct, "Congress would either have to pony up more money ... or risk the wrath of those who signed up for the program only to have it pulled out from under them," said Timothy Stoltzfus Jost, a professor at Washington and Lee University who specializes in health-care law.
Here's more on this below:
Called a "high-risk pool," it would be a special health plan just for people with preexisting conditions, who are costlier to insure. A plan just for sick people could require extraordinarily high premiums. However, to make it more affordable, the bill would set aside $5 billion for federal subsidies. According to Foster, that's not enough.
"By 2011 and 2012 the initial $5 billion in Federal funding for this program would be exhausted, resulting in substantial premium increases to sustain the program; we anticipate such increases would limit further participation," he wrote.
So we have a high risk pool that has high premiums for those with pre-existing conditions. Can they afford the premiums even with the subsidies? We don't even know the numbers of how much the premiums would cost with these subsidies, but it's a question that needs to be answered, given the videos by our nyceve of sick Americans who desperately need affordable care without being fucked over by co-pays, deductibles, and out-of-pocket costs. And in order to qualify for this high-risk pool, people have to be uninsured for six months.
The bill does give the Secretary of Health and Human Services the power to "shall make such adjustments as are necessary to eliminate such deficit" if the subsidies are inadequate. The Washington Post reporter, David S. Hilzenrath, seems to think it extends to the possibility of freezing enrollment.
To me, I say that $5 billion isn't enough for sick and dying Americans who desperately need real health care reform, and nor is this high risk pool an effective measure in addressing the denials of claims and being unable to get insurance due to pre-existing conditions until 2014.