Last night, Fox News’ Greta Van Susteren pressed Rep. Steve King (R-IA) on how repeal of health care reform would help the uninsured or the poorest Americans who can’t afford to purchase coverage. King first responded, “There will always be those who slip through the cracks,” then tried to dodge the question by arguing that just 12 million would be left without coverage should the law be eliminated. “That’s less than 4 percent of the population. And it’s wrong for us to try to change 100 percent of the policy to address less than 4 percent of the population in America,” King said.
But Van Susteren pressed further, asking, “With that 4 percent, that 12 million, what would you do with them?,” and exposing the GOP’s lack of a solution for extending coverage to the uninsured:
KING: You know, that’s a little bit different kind of a situation, and the states can deal with that. And we can subsidize some of that. Some of those people that are in that list are those who have pre-existing conditions.
VAN SUSTEREN: What do we do about them?
KING: We can step in and help the states establish those policies to address those high risk pools. That’s one of the ways to deal with preexisting conditions, and I think that will go a long ways towards — and it’s constitutional.
VAN SUSTEREN: What about the very poor?
KING: The very poor have always had access to Medicaid. And the Medicaid policy is there, and there’s something like 9.7 million Americans who qualify for Medicaid that just simply don’t sign up. So that policy’s there for those who are the very poor. We will take care of those. But we need to also make sure that the incentives for those who will take care of themselves are there, that we don’t lower everybody down to the lowest common denominator and punish people for being personally responsible.
King’s solution to help states establish insurance programs for the sickest Americans — so-called high-risk insurance pools — is already part of the Affordable Care Act, but the programs have thus far failed to attract enough enrollees. The problem is that insuring large groups of sick people who need constant medical attention is expensive and even though the law requires premiums for the high-risk plans “to track those charged by private insurance plans for customers in good health, those rates have still proven unaffordable for many,” charging approximately $300 per month for coverage.
A more sustainable solution would be precisely what King suggests — ensuring that there are incentives “for those who will take care of themselves” that don’t “punish people for being personally responsible.” He is inadvertently making the case of an individual mandate, without which it’s very difficult to encourage healthy people to enter the risk pools and offset the costs of treating the sick.
Cross-posted on The Wonk Room.