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McCain’s High-Risk Pools — A Gift To The Insurance Industry

Yesterday, during Sen. John McCain’s (R-AZ) “tele-townhall meeting,” Debbie, a woman who was laid off her job and subsequently denied health insurance in the individual market because she was taking “blood pressure medication,” asked McCain if his health reform plan would “reform the insurance business” and help her find coverage.

McCain conceded that Americans with pre-existing conditions would have a hard time finding coverage in the unregulated market but reassured Debbie that she could find coverage in government subsidized high-risk pools:

We have to develop – the state of FL is starting to develop them – government approved plans. Which is the legislatures and the governors and the federal government join together with the Federal government making a very significant contribution so that they can establish risk pools and others and make sure that every American is able to get – particularly with somebody like you – that basically can’t get insurance, can get affordable and available insurance and the government is going to have to weigh in physically and financially to see that you get the ability and the health insurance that you need…These are tough times and a lot of people facing the same challenge you are, Debbie. I’m committed to fixing it.

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But McCain’s “fix” is inadequate. As the Wonk Room has previously explained, high risk pools have many of the same draconian limitations as the unregulated private market: waiting periods, premiums that are out of reach for many families, substantial deductibles and co-pays, and limits on mental health and maternity care.Moreover, experts estimate that McCain’s “very significant contribution” to high risk pools is not significant at all. In fact, according to most experts, McCain’s proposal to boost funding by $7 to $10 billion is “nowhere near enough, [to cover the uninsured] particularly given the large number of people with pre-existing conditions who would need this help if employers send their workers out to the open market.”

Thus, Americans like Debbie would have to pay outrageous premiums and deductibles for health insurance because high risk pools, unlike general risk pools, don’t spread risks and costs across a mixed pool population of healthy and sick people. She would pay more for insurance because, under McCain’s plan, her pre-existing condition would force her into a pool that cannot offset the costs of treating her condition.

In some ways, McCain is right. He would “reform the insurance business.” But rather than increasing access to health care, McCain’s plan to subsidize high risk pools would only release insurance companies from covering sicker people.

Rep. Burgess: McCain’s Plan Would Insure More Americans Than Obama’s

Yesterday, Rep. Michael Burgess (R-TX), the architect of Sen. John McCain’s (R-AZ) health care plan, falsely claimed that McCain’s health reforms would come closer to insuring every American “than will Senator Obama’s.”

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As he has in the past, Burgess completely misrepresented the intent of McCain’s plan. In fact McCain’s proposal is predicated on the idea that everyone is getting too much health care. Rather than expanding access and making health insurance more affordable, McCain believes that families should have to pay more money out of pocket in order to reduce the amount of care delivered.

CLAIM: McCain’s plan “comes a lot closer to the ideal goal of offering every American the opportunity for insurance.”

FACT: McCain’s plan would not come close to insuring the 47 million Americans without health care.

- By equalizing the tax treatment of employer and individual plans, McCain would entice healthy workers to buy cheaper but less substantive insurance in the individual market place. The exodus of healthier workers from employer-pools would increase the average health care costs for sicker employees who can’t find coverage in the individual market, forcing them to opt out entirely.

- As the Center for American Progress Action Fund pointed out, the entire employer health insurance system could unravel, “ending this as an option for Americans who prefer it.”

CLAIM: Under McCain’s plan the uninsured would be able to purchase insurance because “the employer can provide…additional compensation to in a employee over and above the $5,000 tax credit that that employee could use to purchase insurance for themselves or family.”

FACT: Average premiums are higher than McCain’s credit of $2,000 for an individual and $5,000 for a family.

- According to the Kaiser Family Foundation, “the average annual premium costs for a family with employer-sponsored insurance was $12,106 in 2007, and it was $4,479 for a single person.”

- Annual premiums for nongroup coverage vary widely, currently ranging from $1,163 to $5,090 for singles, and $2,325 to $9,201 for family coverage.

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