Under the terms of the Affordable Care Act all the states were required to implement high risk pool plans to insure adults under age 65 who had preexisting medical conditions. The availability of individual health insurance for people with medical conditions was almost non-existent before the passage of health care reform.
Congress may have understood the need for providing access to health insurance for Americans with medical conditions but the good intentions got lost in the implementation.
What is affordable?
About half the states opted out of running their own high risk pool plans and have signed on to the high risk pool plans run by the Department of Health and Human Services (HHS). Operating under the name the Preexisting Condition Insurance Plan the program is similar in most states but the premiums vary.
Affordability is in the eye of the beholder. It is true that the premiums offered under the high risk pool plans are somewhat less than those offered by the high risk pool plans which had been offered in about 35 states prior to the passage of the Affordable Care Act.
But premiums that are less than exorbitant cannot realistically be called “affordable.” For a complete list of the states that participate in the HHS program, click here.
What many people do not understand is that the quoted rates are for each individual. So, in Nevada for instance, a 56 year old who has a preexisting condition that precluded getting individual health insurance in the past, would have to pay a premium of $714 a month. If a couple needed coverage because both had some medical conditions, their monthly premium would be $1428 per month.
With an annual premium of over $17,000 for a couple in their late 50s, I’m not sure how many people would consider that premium “affordable.”
There is a wide variation in premium rates. That same 56 year old couple would pay only $1180 if they lived in Mississippi. But if they move to Florida the rate for the couple would be $1546.
State run plans don’t get much better
The states that are running their own plans are not offering their citizens much of a break. Connecticut runs its own plan. The couple in their late 50s who both need coverage because of preexisting medical conditions will be billed a premium of $1255.56.
The high risk pool plans are not what most would consider “ good” health insurance. A complete analysis of how the plans work will follow.
What do you consider affordable? How much do the pool plans help? Post your comments, opinions and concerns and make your voice heard. For the latest SUBSCRIBE here and stay a part of the discussion.