The Republican healthcare bill treats people differently according to whether they’re healthy or have a pre-existing condition. Their strategy is to “protect those with pre-existing conditions by funding state-level high-risk pools.”
Sounds good, right? Sounds like they want to protect people who are ill. But do they really?
Here’s how insurance works with and without high-risk pools:
Say you and your friends have insurance with the same company. Some of your friends are healthy, and some are not. Even so, you each pay a premium of $500 a month. The company uses that money to pay your medical bills. It pays out a lot for people who are ill and nothing or next-to-nothing for people who are not.
Now suppose the company was only willing to insure healthy people. If you were one of them, your premium would probably go down because the company wouldn’t have to pay out for sick people.
But what would happen to the sick people? And what would happen to you, if you were one of them or if a family member was one of them?
Here’s what the Republican House bill would do:
The bill would group the sick people – people with pre-existing conditions – together. They would form a high-risk pool. Their premiums could go as high as $25,700; their deductibles could skyrocket to between $1000 and $5000 or more. How else could the company pay for all those medical bills?
Supposedly, there’d be state funds to help people with the premiums. But experts say it wouldn’t be enough by a long shot. The House healthcare bill puts aid at less than half the money needed to make the high-risk pools affordable.
Creating high-risk pools may be fine as long as you’re not in one of them. But don’t count on it. Here are some conditions that would put you in a high-risk pool.
| • high blood pressure | • arthritis | • upcoming surgery |
| • high cholesterol | • diabetes | • heart failure |
| • asthma | • obesity | • lupus |
| • anxiety | • depression | • bipolar disorder |
| • Crohn’s disease | • Pending hospitalization | • cancer |
| • alcohol/drug abuse with recent treatment | • pregnancy or expectant parent (includes men) | • Alzheimer’s/ dementia |
Up to 7.6 million of us would end up in high-risk pools and spend up to 40% of our after-tax income on health care. Would you be among them? If not today, someday?
The Republicans don’t seem to care.