AP
If you maintain coverage continuously, insurers won't be able to raise your premiums because of them, Republicans say. If you don't maintain coverage, you'll still be able to buy insurance, subsidized to the point of affordability, through a "high-risk pool."
They say this system will be just as good as Obamacare for people with preexisting conditions.
They're lying.
Most states operated high-risk pools before the Affordable Care Act, and they tended to run out of money, because providing insurance to sick people is expensive. States ended up capping enrollment, and/or setting premiums so high they remained unaffordable even after a subsidy.
The amount of money provided for high-risk pools in the AHCA ($8 billion, plus another $130 billion that states may use for high-risk pools but can also use for other purposes, over a 10-year period) is obviously insufficient to provide affordable coverage to everyone who would be priced out due to a preexisting condition in their plan. It sets up a repeat of the pre-ACA situation, where people who have a preexisting condition and a gap in coverage will be unable to buy affordable insurance.
But it doesn't have to be that way. If Republicans were genuine about wanting to protect the sick through the high-risk pool approach, there is something they could do.
If they want to make a credible promise to cover people with preexisting conditions, they shouldn't create a fixed-dollar fund that might run out. Instead they should define the benefit.
That is, their bill should specify who is entitled to a subsidy for insurance due to high medical costs, specify what such insurance must cover, and specify the price to which the subsidy must lower the net premium to be deemed "affordable."
This is how Medicare and Medicaid work: Instead of a fixed-dollar appropriation, anyone who meets legal requirements is entitled to participate in these programs, and the government spends what is needed to pay the promised benefit to everyone who is entitled. That's why they're called "entitlements."
If Republicans think the chronically ill are entitled to medical coverage, they should create an entitlement to pay for such coverage. And if problem of preexisting-condition coverage is as limited in scope as conservative commentators say it is, the costs shouldn't be too eye-watering.
A new healthcare entitlement might sound like a not-conservative idea, but Republicans created one in 2003, when they added a prescription-drug entitlement to Medicare. And an entitlement for high-risk pools is approximately what's proposed by Chris Pope, a senior fellow focusing on health policy at the Manhattan Institute, a right-of-center think tank.*
Instead of creating a new high-risk pool, Pope proposes to leave the chronically ill on existing Obamacare exchanges. He'd let healthier customers leave the pools to buy insurance plans that offer lower premiums to align with their low expected healthcare costs. He also expects (reasonably) that a lot of healthy and uninsured people, who currently reject Obamacare exchange plans on the grounds of price, would choose to buy such plans outside the exchanges.