Few Purchase High Risk Pool Insurance

The establishment of a federally-funded temporary high risk pool is among the components of the Affordable Care Act that were implemented early on. By design, the federally-funded high risk pool provides transitional coverage to 2014 for the currently uninsured with preexisting conditions.  Of course, effective January 1, 2014, the Affordable Care Act prohibits health insurers from basing coverage or pricing decisions on health status, assuming the Act is not repealed. High risk pools exist currently in 35 states.

Illinois identified approximately 1.4 million eligible members for the Illinois Pre-Existing High Risk Pool (IPXP).  The Illinois enrollment experience to date of this federally subsidized program offering good insurance for those who currently don't have it, is only moderate at best.  Currently there are fewer than 5000 members, less than 0.5% of those eligible.  There are four different pricing options from which to choose, and the benefit designs also cover much of the costs related to pharmaceuticals.  The Illinois experience is typical...once prospective members realize they must still pay a premium and additional out-of-pocket costs, they opt to remain uninsured.

Part of the uninsured problem in America is simply a matter of personal choice to go bare. The law prohibits providers of emergency services from with-holding life sustaining care, so everyone needing urgent care can get it.  The costs associated with uninsured care are passed to those who can pay, including the taxpayer.  We all know other examples of deadbeats in our lives and it is indeed rare that government regulations are very effective as a remedy.  Left to our own creative ways, however, we will deal with deadbeats in all sorts of ways hopefully still in keeping with legal, moral and ethical standards. Peer-to-peer confrontation and holding one another accountable where accountability is appropriate (i.e. moral), is usually more effective than enacting more law.

Whether or not the Supreme Court upholds the individual mandate, there will be many who simply will not buy the insurance nor pay the penalty/tax. The Pre-Existing Uninsured High Risk Insurance Products are showing us what is to come.  While some of the public policy intent behind the Patient Protection and Affordable Care Act is to provide us a better system of care, the failure to follow solid free market economic principles will result in a cost-prohibitive outcome.