The non-partisan Congressional Budget Office says that under the GOP proposed American Healthcare Act 24 million people may be uninsured in 2026 if the bill changes Medicaid funding along with changes to subsidies for insurance.
A recent teleconference has some consumer groups raising concern that a repeal of The Affordable Healthcare Act may lead to the return of so-called high-risk pools.
Prior to the Affordable Care Act, health insurers could deny people with pre-existing health conditions. To help those who were denied coverage, 35 states including New Mexico established so-called high-risk pools to help insure those who were denied coverage due to a chronic illness.
The American Healthcare Act doesn’t establish high-risk pools, but in a recent teleconference hosted by consumer health watch groups, some say a repeal of The Affordable Care Act could bring back high risk pools which may be funded by federal dollars set aside for states in block grants in the GOP bill.
Cheryl Fish-Parcham, Director of Access Initiatives at Families USA, a healthcare consumer watch group, says the money allocated in the bill for possible high-risk pools is not enough. She says that high-risk pools had some problems for consumers, like waiting periods for care.
“If you’d been uninsured for a time and then turned down by another plan, and now you were buying this expensive high-risk pool coverage you might still pay premiums for twelve months before the plan covered the care you that you needed for your existing health condition,” says Parcham.
Parcham says high-risk pools had a lifetime limits or annual maximums which could impact coverage for some with certain chronic illnesses. Also, she says the premiums were very high for many of the pools that existed before the Affordable Care Act.
“Only a few had generous enough subsidies to be affordable to people with generous to modest incomes,” says Parcham.
According to The National Conference of State Legislatures, New Mexico had an average of just over 8,400 (8,430) members in its pool in 2011, which was established in 1988, the eighth highest out of states with pools at that time.
