The media are finally waking up to the fact that the temporary high-risk pools created by the new health-care law were completely unfunded. Only $5 billion was set aside for the program, which is probably less than a third of what would be required to keep the program funded until 2014. This should not be news to Congress or people closely following the health-care debate. Back in December 2009, the Center for Medicare and Medicaid Services (CMS) clearly concluded, “By 2011 and 2012 the initial $5 billion in Federal funding for this program [high risk pools] would be exhausted.” A fact FDL chose to highlight.
As little as a year ago, this would not have had to become a major problem. I would have expected Congress in 2011-2012 to provide the needed additional funds for the high-risk pools, preventing hundreds of thousands of people from losing their health care. That is before I witnessed the recent fight to kill the tax-extender bill, which contained COBRA subsidies, emergency Medicaid funding and unemployment insurance extension. A cruel indifference to the plight of regular people and fake deficit hysteria have taken over the Senate. The added funding for the high-risk pools may suffer the same fate. This is one of the many foolish political time bombs Democrats wrote into their own health-care bill. They cared more about some CBO price tag than doing it right.
The foolishness of creating new state-based public/private hybrids for health insurance
The trouble that states and the federal government are having with setting up the high-risk pools in time demonstrates an important lesson about the absurdity of creating state-based public/private hybrids to provide health insurance, which the new law does with high-risk pools and eventual exchanges. The decision was idiotic, given that the government for decades has been running the public health-insurance program, Medicare, and providing quality health insurance cost effectively.
Instead of creating these high-risk pools, Congress could have decided to provide the people most in need of health insurance with Medicare. They would have started to receive benefits more than a month ago, and the money would have covered more people. Instead, many will wait at least until August before getting help.
We have proof that expanding Medicare could have been done much quicker. Sen. Max Baucus (D-MT) made sure to include a provision in the law to expand Medicare to the victims of asbestos contamination in Libby—in his home state. I can happily report that less than two months after the President signed the new law, people in Libby were getting their Medicare cards. Too bad Baucus doesn’t use his powerful Finance chairmanship to make sure millions of other Americans in need also get help so quickly.





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Wow. Who could have seen this coming? Not the brainiacs in the MSM.
But seriously what’s going to happen is they’re going to limit the size of the pools. Here in Cali they decided the pool will be about 25,000 people. How’d they figure that? It’s a crude back-of-the-envelope calculation of how many people they could cover at $8650 each for $761 million over 3.5 years. The current California state program, with 7000 enrollees, pays 40% of premiums (really 30% because premiums are 125% the market average), which is shabby compared with the new federal program which will pay 65% of market average premiums. So there’s going to be a gold rush to get into the new program.
Like the gold rush, a few people will do well. The rest wait for 2014 and hope for the best.
I can happily report that less than two months after the President signed the new law, people in Libby were getting their Medicare cards. Too bad Baucus doesn’t use his powerful Finance chairmanship to make sure millions of other Americans in need also get help so quickly.
Well played sir. No one can deny the folks of Libby Montana deserve medical coverage despite their pre-existing conditions, but that section of the bill should be amended to offer Medicare coverage to every American with a pre-existing condition (or better yet, every American full stop).
I just looked up the bill section — SEC. 10323. MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS– man every bill should have this clause, sure to drive the CBO bonkers –
8) WAIVER OF BUDGET NEUTRALITY.—The Secretary shall not require that pilot programs under this subsection be budget neutral with respect to expenditures under this title.
Since we’re likely to see people get sick or have their health threatened by the BP oil spill, I would take note that the Secretary is given “discretionary deeming” authority to enroll victims of other environmental health emergencies into Medicare. Whether its asthmatics who takes ill from crude oil fumes or if we’re faced with a Katrina-style masss evacuation, Sebelius has the authority to create “optional pilot programs” with coverage eligibility starting “the date of such deeming” and is given broad waiver powers so premiums and other paperwork shouldn’t hold anyone up. If the Administration can be bothered to act, it will be interesting to see how AHIP lobbies against it. :o)
And they got no credit for that. I have less of a problem with corruption than I do with the epic incompetence of Dear Leader and the Democratic Party.
Why does the time bomb have a fuse?
You’ll find fault with anything. Now you’re griping about a cartoon bomb?
I only see three possibilities of their failures and determination to go down the same paths to failure over and over:
1) They are too stupid to understand that they are never going to tempt Republicans to vote for legislation, no matter how far right they allow themselves to get pushed.
2) They are all collectively insane by expecting that continuing to do the same thing they will somehow achieve a different result.
3) They are playing kabuki and they WANT to fail but are lamely trying to blame Republicans for their failure.
Personally I believe the last possibility is the most likely but all three prove they are unable and unworthy to govern.
ARE THERE NO WORKHOUSES,PRISONS?
let them die and decrease the surplus population
the Scrooge kleptocrat CONGRESSCRETINS
the democrats made their case, and passed the bill, based upon being able to MEET A BUDGET.
they should be expected to actually follow it.
that is how American families must do it.
Jon- do not forget, without making their budget claims, there would have been NO BILL.
bingo
corpratist congresscretins of both parties
“I would have expected Congress in 2011-2012 to provide the needed additional funds for the high-risk pools …..”
You proceed from the false assumption that health care reform was about health care.
HCR was a health insurance bailout from the very beginning, Privitize profit and socialize liabilities.
biddness as usual!
Bingo. I’ve been calling it the Insurance Company and Pharmaceutical Welfare and Giveaway Act for months now.
Lighten up.
I wasn’t finding fault or griping, I thought it was humorous.
They never had any realistic idea of what HCR would ultimately cost, and still don’t.
we can all blame Joe Lieberman.
he is the one who killed Medicare Buy-in at 65.
With that, the high-risk pool population would be cut significantly.
The first two opening sentences of this piece were completely contradictory…
HC “reform” is so 2009 don’cha kno?
The new and much easier way to play the rubes with both coming and going is “deficit reduction”. As seen with Petey Peterson’s SS Must Be Cut Shambalaya Road Show. Or will surely be seen between here and 2014 as Magician Obama’s “Yes We Can” approved HCR unfurls and is seen for what it is/was not.
Deficit Reduction is the perfect fiscal/political weapon of choice for the lizards we call our “political leaders” in WashingtonDC. Plays on the “cut my taxes now” rubes and just sounds so “responsible and prudent” while it is used to gore some government programs but not others.
Needed additional funds for the high risk pools? Oh sure…right away.
AHIP and PhRMA got what Obama gave them. The rest of us? Get outta here.
Deficit Reduction — the new fiscal/political gameplan — has been rolled out. It’s so Bi-Partisan. Barack Obama will throw a lot of smiles to make it sound and look so responsible and prudent. You need healthcare? Obama sold you out. AHIP and PhRMA get the money. You? Get a job with some bennys and pay your way — slacker — sheesh.
A society of sheep must in time beget a government of wolves.
Bertrand de Jouvenal
Meanwhile, I’ve referenced this post in a DKos diary. Feel free to read/rec if so moved. (Be interesting to see if the usual suspects start an influx of pootie and woozle diaries to shove this one off the diary front page before it can be Rec Listed. ;-)
What is going to improve in 2014?
the absurdity of creating state-based public/private hybrids to provide health insurance, which the new law does with high-risk pools and eventual exchanges.” ???
exchanges are nothing – they act as a broker would – telling you what is available. Not much of a “state hybrid” and indeed near zero cost control unless the Federal Gov determines both benefit structure and max cost to be charged.
The high risk pools on the other hand are classic anti-selection because of there is a very high premium – only the most costly will join and the $5 billion will not be enough for the claims exceeding the premium problem – meanwhile the removal of these folks from the insurance company risk assumption will not be passed on to us as lower premium – instead the companies are redefining claims to include costs that were previously overhead, allowing the cost savings from the gov taking over this risk to flow directly to the ins co bottom line – or the CEO’s bonus.
they also provide the billion in subsidies. They are more than simple brokers.
Yes, the now have a more formidable excuse to help the corporations put
more of their feet on our necks.
The exchanges are the premium collectors and indeed move the money onto the ins companies after they add the subsidy
I believe Federal – the only version that did anything for competition – was dead – and that in the state version individuals had rights to subsidy that would be granted via the purchase on the exchange. So the subsidy is not provided by the exchanges, but they do administer the individual’s Federal credit toward the premium – at least until 2015 when the money to set up state exchanges ends.
The state exchanges exist as a marginal idea that only applies to those not covered by employers. Sort of an outlet shopping model for health-care, accessible only to the few able to get there, where “few” means no effect on competition and “few” is – because it is by state – very few.
Jon, I see the federal high risk pool website is now up… the pool is now called “the pre-existing condition insurance plan”
http://www.pcip.gov/
Oh and they’ve come up with a clever way to limit eligibility. To “uninsured for at least 6 months” is added the requirement of an a rejection letter dated WITHIN the the past 6 months. So now anyone who’d been rejected by insurers longer than 6 months ago has to reapply just to be sure… and to give insurers a chance to offer coverage at sky-high premiums instead of a rejection letter.
And if you don’t afford those premiums, tough. Only in Mass. is there a price cap for adult premiums. I have to admit, If the goal of Obama’s healthcare reform was to deny people healthcare while making sure private insurers get every dollar in premiums possible, he’s off to a good start.
A copy of a letter dated within 6-months of your application from an insurance company or health plan showing that you have been completely denied individual coverage because of a pre-existing condition, or you were offered coverage but were denied certain benefits (for example, by a rider to an insurance policy) because of a pre-existing condition.
For children under age 19 or persons who live in Massachusetts only: A letter that shows you were offered coverage at a premium that is at least twice as much as the Pre-Existing Condition Insurance Plan premium (the monthly payment you make to an insurer to get and keep insurance) for your state.
http://www.pcip.gov/Apply.html