Wednesday, July 9, 2008


NY Times In late April, Mr. McCain, Republican of Arizona, announced that if elected president he would seek to insure people . . . by vastly expanding federal support for state high-risk pools like Maryland’s, or by creating a structure modeled after them. . .

Though high-risk pools have existed for three decades, they cover only 207,000 people in a country with 47 million uninsured, according to the National Association of State Comprehensive Health Insurance Plans. Premiums typically are high, as much as twice the standard rate in some states, but are still not nearly enough to pay claims. That has left states to cover about 40 percent of the cost, usually through assessments on insurance premiums that are often passed on to consumers.

Health economists say it could take untold billions to transform the patchwork of programs into a viable federal safety net. The McCain campaign has made only a rough calculation of how many billions would be needed and has not identified a source for the financing beyond savings from existing programs. Finding the money will only get more difficult now that Mr. McCain has pledged to balance the federal budget by 2013, which already requires a significant reduction in the growth of spending.

Mr. McCain's proposal stands in sharp relief to that of his Democratic rival, Senator Barack Obama of Illinois, who wants to require insurers to accept all applicants, regardless of their health. That is now the law in five states, including New York and New Jersey.

For those who can afford the premiums, or who qualify for subsidies in the 13 states that provide them, the high-risk programs can be a godsend. . . A fifth of the 14,000 participants in the Maryland plan receive subsidies that drop their premiums below the market rates charged to healthy people, said Richard A. Popper, the plan’s director. But many in the middle find the policies both unaffordable and intolerably restrictive, and Mr. Popper estimates that two-thirds of those eligible have not enrolled.

Almost all of the state pools impose waiting periods of up to a year before covering the health conditions that initially made it impossible to obtain insurance. In some states, fiscal pressures have forced heavy restrictions in coverage and enrollment. Florida, which has 3.8 million uninsured people, closed its pool to new applicants in 1991, and the membership has dwindled to 313. . .

There is no census of the medically uninsurable. But in 2006, insurers turned down 11 percent of all individual applicants for medical reasons, including 22 percent of those 50 or older, according to America’s Health Insurance Plans, an industry trade group.


At July 9, 2008 1:24 PM, Anonymous m said...

We all know that McCain is somewhat limited in his administrative capabilities, so we are truly grateful that McCain has decided to follow the same planning process that the MBA president used in program design and oversight.

The primary models used will be the Iraq occupation, Katrina relief response, the Medicare pharmaceuticals plan, Homeland Security, and of course national debt doubling.


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