Why are high-risk pools having so much trouble?

[eridani]

The whole notion of a "market rate" for insurance is morally appalling.

http://www.washingtonpost.com/blogs/ezra-klein/post/why-are-high-risk-pools-having-so-much-trouble/2011/06/01/AGbBVZGH_blog.html

Knowing that the major changes under health reform wouldn’t kick in until 2014, Democrats made sure to frontload the legislation with provisions that would take effect immediately. But among these “early deliverables,” one has had a particularly tough time catching on. Low enrollment continues to plague the new high-risk insurance pools for Americans with preexisting conditions: Only 18,313 have signed up as of March, light-years behind the 200,000 people that the Congressional Budget Office estimated would sign up by 2013.

The flagging numbers have prompted Obama’s Health and Human Services Administration to take big steps to make the high-risk pools more enticing. Insurance rates in many of the pools were already below market rates, but HHS will now dip even further into the $5 billion dedicated to the program to reduce premiums by as much as 40 percent, as the Wall Street Journal notes. Perhaps more significantly, the administration will also relax the enrollment requirements, dropping a provision that required participants to show a denial from an insurance company or an offer of insurance at twice the regular rate.

<snip>

But the political controversy surrounding health reform has quickly overshadowed the specific questions and issues surrounding its implementation. Coming into the new Congress, Republicans put the repeal of the Affordable Care Act at the top of their agenda, putting Democrats on the defensive and drawing out the debate over whether the legislation should exist in the first place. In recent weeks, moreover, Democrats have been consumed by their offensive against Republican Rep. Paul Ryan’s plan to overhaul Medicare, again taking the focus off putting the ACA into effect.

Perhaps as a result, many Americans remain clueless about what’s in the Affordable Care Act — and even whether it still exists. As recently as late February, a poll conducted by Kaiser Family Foundation found that nearly half of Americans thought that health reform had been repealed or said they didn’t know whether that was the case. Within that context, it’s not surprising that so few Americans are rushing to sign up for a special insurance program that, up until recently, had relatively stringent requirements for participation.

[TheKentuckian]

1. I don't know what part of people can't afford it that is so hard to understand.

The other part about not being able to afford care if one can scrap up the blood money for premiums completely and utterly misses most, apparently.

The entire approach is a mess. Refusing to address the jacked up system and costs means a whole lot of pissing into the wind and spreading the same systemic pain a bit more evenly but continuing to inflict the same amount or more in the process.

[eridani]

2. Even loweing the premiums isn't going to be much help for many

And there is still the problem of the outrageously high deductibles, which will prevent even those who can afford the insurance from actually using it.

[Roselma]

3. Each state is different, but our problem in Maryand is cost. That

said, if you've got a preexisting condition that requires medical intervention, having to go 6 months without any insurance, then having to collect reject letters from insurance companies makes participation undesirable. It is almost like the barriers to participation can't be overcome.