High-Risk policies, indeed…

Last week, one aspect of the McCain health plan was highlighted by Kevin Sack of the New York Times , in an article entitled, “McCain Plan to Aid States on Health Could Be Costly.” It lays out the problem:

“If Senator John McCain’s radical plan for remaking American health care is to work, he will have to find a way to cover people like Chaim Benamor, 52, a self-employed renovator in this Baltimore suburb…. After being rejected by a number of commercial carriers, he turned to the Maryland Health Insurance Plan, one of 35 state programs for high-risk applicants whom no private company is willing to insure.”

The McCain plan would eliminate the tax benefits for employer-based coverage, and thus push people from on-the-job group coverage into the individual market, where consumers (except in a few states) can be denied for “pre-existing conditions.”

So what happens if one is denied? In California, your only option is the state’s “high-risk” pool, MRMIP, the Major Risk Medical Insurance Program… but that now has a waiting period of over 1,000 patients!

And that’s a program that has never been advertised, that’s more expensive premiums than already-expensive market rates, and that caps annual benefits at a mere $75,000–less than a week in many hospitals.

Even though we suspect that the number of willing-to-pay-but-“uninsurable” customers are in the hundreds of thousands, the McCain plan would make this worse. And his only solution is to provide some federal assistance to plans like MRMIP. The question is: will it be enough?

With the new attention on the individual insurance market and “high-risk” pools, the Kaiser Family Foundation is hosting an “Ask the Experts” webcast tomorrow (Tuesday) at 10am Pacific Time on the subject. One of the experts is California’s own Lesley Cummings, executive director of the MRMIB, which runs MRMIP. It should be interesting to hear her answers to question coming from a national perspective.

Don’t get me wrong: MRMIP needs help and resources as soon as possible–AB2(Dymally) is a longstanding pending bill on this subject that Health Access California supports.

But the real solution is to reduce the number of people denied by insurance companies in the first place, either through the market power of group coverage, or by significantly regulating the individual market. Even in the context of health reform that does both, like in AB x1 1, it made sense to maintain and improve the high-risk pool to make sure the safety net was in place and strengthened for those who fall through the cracks.

What makes no sense is to make the problem worse, and pretend these already struggling problems are the solution.

Health Access California promotes quality, affordable health care for all Californians.

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