One of the sticking points of the American Health Care Act, also known as Trumpcare, is the area that concerns people with pre-existing conditions. The latest version of Trumpcare is planning to go through the Congressional Budget Office this coming Wednesday. According to the Republicans, Trumpcare will be able to provide protection for people with pre-existing conditions.
According to the latest version of Trumpcare, if a person maintains coverage continuously, the insurance companies won't be able to raise the premiums. On the other hand, if an individual is unable to maintain coverage, he or she will still be able to buy insurance to a point where it will be "affordable" because of the help of the "high-risk pool" subsidy. According to the Republicans, it's still as good as Obamacare.
Now, a lot of experts are saying they are simply lying.
According to some experts, high-risk pools are not a new thing. Most states were already operating high-risk pools even before Obamacare. The problem with such a solution is the tendency to run out of funds. As a result, states are either setting the premiums to "unaffordable" levels or they start capping the enrollment.
Experts are saying that it doesn't need to be this way. There is a way to avoid such problems by carefully managing the terms. According to experts, creating a fixed-dollar account is not the best way of managing the system as it can lead to depletion of funding. A better way may be to define the benefits.
As proposed by experts, what they can do is to alter the Trumpcare bill to specify who is entitled to subsidy because of the high medical costs. The bill should also specify the insurance coverage. Lastly, the bill should specify how much the subsidy will cover so the insurance would be considered as "affordable."
This is how Medicaid and Medicare work. Rather than placing a fixed-dollar appropriation, individuals must meet the legal requirements before they can participate in the program. One issue with such program is how to transition the current insurance holders into the new system.
According to Chris Pope, a specialist of health policies from Manhattan Institute, rather than creating and implementing a new system of high-risk pools, he proposes that current insurance holders who are chronically ill simply stay on the existing Obamacare. For the healthier individuals, Pope proposes that they should be pushed out from the existing Obamacare to take on the new system brought by Trumpcare.
Of course, if you allow an individual to discontinue Obamacare and take a new one, this could mean a discontinuation of the current insurance plan and may leave the individual vulnerable to a premium increase by the insurance companies. To solve this issue, Pope proposes that the bill should also include a cap on how much an individual should pay for the insurance and the state should subsidize the remaining bill. According to Pope, such a solution would be preferable to simply running out of money.