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Advocates: High-Risk Pools Put Sickest Arkansans at Risk

House Speaker Paul Ryan explains the American Health Care Act at a news conference last month. (Somodevilla/GettyImages)
House Speaker Paul Ryan explains the American Health Care Act at a news conference last month. (Somodevilla/GettyImages)
May 30, 2017

LITTLE ROCK, Ark. – As health care advocates evaluate the proposed American Health Care Act (AHCA), many are deeply concerned about its use of “high-risk pools” to cut costs.

The pools would take the sickest Americans out of the insurance marketplace and put them under a separate, subsidized plan, rather than give them the equal coverage they currently receive.

Herb Sanderson, state director of AARP Arkansas, says high-risk pools have a checkered past in the insurance marketplace and could prove disastrous for Arkansans.

"Insurance works best when the risk is spread over a large population, so putting very sick people in a pool just historically has not proven to be a viable solution," he points out.

Under the Congressional proposal to replace the Affordable Care Act, also called Obamacare, states could opt out of the federal plan and enroll people with chronic conditions in a subsidized pool.

Sanderson says, in theory, the plan would cut expenses in the insurance marketplace by removing the patients that cost insurers the most.

But he says the devil is in the details, pointing out that a recent study by the Urban Institute found proposed funding levels for high-risk pools in the federal plan to be woefully inadequate.

"Under the current proposal, they are talking about spending $128 billion over nine years, which is a lot of money,” he states. “But studies show that it would actually cost that much per year to fully fund high-risk pools."

Sanderson says 35 states, including Arkansas, have tried high-risk insurance pools in the past with little success.

An analysis of the AHCA by the nonpartisan Congressional Budget Office, out last week, found that patients forced into high-risk pools could literally be priced out of the market.

"The data shows that premiums skyrocket, even up to $25,000 a year, and even at that rate one might have to wait up to a year to get coverage – and then the coverage they get is not that good,” Sanderson says. “It's pretty skimpy."

The U.S. House last month approved the AHCA, designed by Republicans to "repeal and replace" Obamacare. The Senate still has to pass its version of the bill.

Mark Richardson, Public News Service - AR