President Obama stopped shaking hands for a moment today so that he could embrace a sobbing woman whose uninsured sister recently died of colon cancer.

The sister of Stephanie Miller, from Sandusky, OH, would have been covered if Obamacare were fully implemented when she got sick. Instead, the woman was left without insurance and couldn’t get the health care she needed. According to a report from the event, President Obama offered Miller his condolences:

As the president was working the rope line, he consoled a crying woman who was telling him a story. Pool reached the woman, Stephanie Miller, by phone and got these details.

Ms. Miller said her sister, Kelly Hines, died from colon cancer four years ago because she could not afford proper health insurance. She had no employer-provided coverage

“Even after she was diagnosed with cancer, she was told her income was too high for Medicaid,” Ms. Miller said.

“I thanked him for the getting the Affordable Health Act passed,” she said.

One hundred twenty nine million people have pre-existing conditions. The Affordable Care Act will prevent them from being denied care, either by an individual plan or by an employer. Should Republicans repeal the law, as they have promised, those people could once again find themselves in that situation. Republicans’ only solution is to put people like Miller’s sister into unsustainable, high-risk pools, or force them to go without care.

Earlier this week, Mitt Romney confirmed that he would only require insurance companies to provide coverage for Americans with pre-existing conditions if they recently had coverage, leaving millions of uninsured individuals in the lurch.

Romney would not extend pre-existing condition protections to all Americans. Instead, the states would be responsible for creating high-risk insurance pools that provide coverage to sick people who were turned away from coverage. From his campaign:

Fixing our health care system means making sure that every American, regardless of their health care needs, can find quality, affordable coverage. That is why Governor Romney supports reforms to protect those with pre-existing conditions from being denied access to a health plan while they have continuous coverage. And for those purchasing insurance for the first time, he supports reforms that empower states to make high risk pools more accessible by using cost reducing methods like risk adjustment and reinsurance.

But Obamacare already includes a temporary high-risk insurance pool for people with pre-existing conditions. And the GOP-inspired provision — the idea was part of Sen. John McCain’s (R-AZ) health care plan in 2008 — has failed to provide an adequate coverage solution. As Republicans themselves have pointed out, fewer people than expected have enrolled in the program and costs costs have been double what government officials expected because enrollees in the plan are older and tend to use more health care services. Without younger, healthier people to share the risk of the insurance plan, the premiums increase for those who enroll.

Or, as Romney himself explained to Jay Leno in March, insuring large pools of sick people is unsustainable. “You’ve got to get insurance when you are well and then if you get ill, you are going to be covered,” he told the Tonight Show host.

One of the things Americans like most about the Affordable Care Act is that insurance companies can no longer deny people coverage because of a pre-existing condition like cancer or diabetes. That provision will take effect in 2014, but in the meantime, individuals and families with pre-existing conditions can enroll in temporary high-risk insurance pools that provide coverage for those who are can’t find insurance elsewhere.

Since large groups of sick people are very expensive to insure — they spend the premiums they pay into the risk pool — enrollment has lagged behind expectations, as high risk pools attracted the sickest (and more desperate) individuals willing to pay a hefty price for coverage. But since the federal government instituted a series of reforms, enrollment has picked up. In Alabama, for instance, the size of the state’s pool increased six-fold over the last year, when premiums were cut by 40 percent. Other states also saw tens of thousands more Americans join their state’s pools:

The U.S. Department of Health and Human Services reports that as of the end of February, 389 people in Alabama were on the special insurance, an option for people with illnesses that make them a high risk, such as cancer or diabetes. Last February, there were 61 enrollees. [...]

Alabama’s uptick in enrollment follows a national trend over the last 12 months, when enrollment grew from 12,437 to 56,257. The plans are for people who have been denied coverage because of their health status and are struggling to find affordable insurance. To qualify, people must have gone without health insurance for six months and not be eligible for Medicaid or Medicare.

“For too long, Americans with pre-existing conditions were locked out of the health care system, and their health suffered,” HHS Secretary Kathleen Sebelius said in a recent prepared statement. “Thanks to health reform, our most vulnerable Americans across the country have the care they need.”

Alabama is far from alone in seeing higher enrollment. According to the National Conference of State Legislatures, 49 states, plus Washington, DC, saw an increase in enrollment in their high-risk pools last year. (The lone outlier, Vermont, was not listed as having any enrollees in its pool, but is a “guaranteed issue state” which offers policies to all eligible applicants regardless of their health.) The federal government’s contribution to the program — $5 billion — is running out fact, but given the new enrollment numbers, the law is clearly having an impact.

-Zachary Bernstein

The Affordable Care Act’s Pre-Existing Condition Insurance Plan (PCIP) is credited with providing comprehensive health coverage to nearly 50,000 Americans with high-risk pre-existing conditions, according to a report released today by the Department of Health and Human Services. The PCIP is a temporary program intended to make health coverage available and more affordable for individuals who are uninsured — and were likely denied coverage based on their pre-existing conditions — and are ineligible to receive Medicare and Medicaid. Once the health reform law is fully implemented, in 2014, insurers will be prohibited from refusing coverage to any American with a pre-existing condition.

Since its launch in November 2010, there has been an approximate 400 percent increase in PCIP enrollment — specifically amongst older uninsured Americans, who’s serious pre-existing conditions require more intensive and ongoing medical care — with the PCIP program attracting 8,000 new applications every month from August through November 2011.

PCIP enrollees are immediately granted access to the most basic medical treatments, including primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care, preventive health and maternity care, but because of the severity of many of the enrollees’ conditions, 78 percent of the total cost to run the program is spent on providing care for four types of potentially life-threatening medical needs, such as: cancer, circulatory diseases (i.e. coronary artery disease), degenerative joint diseases, and rehabilitative care/aftercare (i.e. radiation and chemotherapy).

In 2011 the Federally-administered PCIP served 628 enrollees with cancer, including 333 enrollees diagnosed with breast cancer, and covered more than 1,000 enrollees with a diagnosis of either ischemic heart disease or heart failure. Assuming that the risk profile of the Federally-administered PCIP population is reflective of the program as a whole, we estimate that the PCIP program served nearly 1,900 individuals with cancer and approximately 4,700 people with heart disease in 2011.

A recent study examined a sample of 1,485 enrollees in 10 state-based PCIPs and found that 18.7 percent of individuals had joint disease, 16.8 percent of individuals had diabetes or other disorders of the endocrine system, and 15.4 percent had cardiovascular disorders. The top five diagnoses or procedures by cost vary by State, but typically include cancers, ischemic heart.

Some states have had trouble getting the high risk pools off the ground and have either relied on existing state programs or offered patchy benefit packages“. The transition to the new pools has been less than flowing, with enrollment failing to meet the Obama administration’s projections, and while most states still have yet to exceed their operating budgets, at least nine have burned through their money and are currently requesting additional funding — Alaska has spent $13 million on just 45 people. Costs have also stunted enrollment rates, as premiums remain impossibly high, even after the federal government’s decision to reduce them in an attempt to appeal to more people.

– Fatima Najiy

Our guest blogger is Emily Oshima, a Research Associate/Policy Analyst with the Health Policy team at American Progress.

Although Newt Gingrich once publicly championed the individual health insurance mandate, he – and other Republicans – now staunchly oppose the idea. During a town hall in Davenport, Iowa on Monday, the former House Speaker argued that while the mandate can prevent healthy people from free riding the health care system, the provision forces “politicians” to “define health care.” Instead, he endorsed economist John Goodman’s “patient power” solution, which uses tax credits to encourage healthier and younger people to purchase insurance before they become sick and shift the costs of their care throughout the health care system. Under Goodman’s proposal, Americans who go uninsured would store away the credit they would have received for purchasing coverage to later spend on “charity care” -– essentially the high risk pools Republicans proposed as an alternative to the Affordable Care Act.

But Gingrich once supported the mandate for a reason. The mandate is the only mechanism that will move America towards universal coverage and ensure that all people have access to quality care. The Congressional Budget Office (CBO) estimates that eliminating the mandate would reduce coverage by 16 million people. Even generous premium credits –- which likely go beyond what’s included in the Goodman plan — would cover only 40 to 50 percent of the uninsured.

The high-risk pools are no more effective. Since covering large groups of sick people is expensive, the CBO found that Republican high risk pools would cover fewer than 3 million patients, while significantly driving up premiums for all by redistributing the high health care costs of some users more broadly. The Affordable Care Act’s temporary pools have encountered similar cost problems. Further, high risk pools require government funding — given recent attempts to slash Medicaid and states’ tight budgets, can we really believe that Gingrich is committed to funding care for “charity”?

What’s more, there are numerous flaws with the structure of his proposed tax credits: They are inadequate –- keeping insurance prohibitively expensive for some –- and would fail to grow with rising costs. Without the regulatory protections of the ACA, Goodman’s plan would also throw millions of people into “the Wild West” of the individual health insurance market, where millions of Americans will be denied or priced out of coverage altogether.

Yesterday, ThinkProgress brought you the tragic story of Kent Snyder, Rep. Ron Paul’s (R-TX) 2008 presidential campaign manager. Snyder, who was the person that convinced Paul to run for the White House, died that same year at 49 from pneumonia because he lacked health insurance. His story is getting renewed attention in light of Paul’s exchange with moderator Wolf Blitzer at CNN’s debate Monday night, in which he was asked what should happen to a comatose 30-year-old man who lacked insurance — someone similar to Snyder. When Blizter asked if the hypothetical patient should be left to die, some members of the audience yelled “yes!”

Now, CNN reports that Snyder lacked insurance because he had a pre-existing medical condition, which “made it impossible for him to find coverage.” Watch the segment from last night’s Situation Room:

There are an estimated 50 to 129 million Americans who, like Snyder, have medical conditions that lead to higher health insurance costs or an inability to find any coverage at all. sSolving this problem is one of the core goals of President Obama’s Affordable Care Act.

By 2014, the law will forbid insurers from charging sick patients more or rejecting them out of hand, a move that is only possible when coupled with the individual health insurance mandate conservatives despise. But even before 2014, Snyder could potentially have been eligible for a federal high-risk insurance pool for people with pre-existing conditions, which was established last year.

People like Snyder, who cannot find affordable insurance, are exactly who the law is intended to help. Even people who hate the law, like Paul — who has said “Obamacare” is “monstrous” and “bad for your health” — may find themselves thankful for it down the road.

I’ve recently been told that liberal groups and blogs are eager to pounce on the administration for not living up to certain progressive principles but rarely highlight instances of accomplishment. And so, it’s in an effort to correct the imbalance that I point to the government’s efforts to reduce health care premiums in the federally-run, high-risk insurance pools — temporary coverage programs for uninsured people who can’t find coverage in the individual market — and encourage more uninsured Americans to sign up:

Uninsured sick people got some good news recently, or some of them did, anyway. Starting July 1, the Obama administration reduced the premiums by up to 40 percent in special high-risk insurance plans that the federal government is running in 17 states and the District. [...]

On the low end, Mississippi will reduce premiums by 2 percent. Several states will cut monthly rates in the 15 to 25 percent range, including the District , which will reduce premiums by 18 percent. Six states, including Virginia, will reduce their premiums by 40 percent.

The change means that a 55-year-old District resident who would have owed $551 per month under the old rates for the standard plan will now owe $450. In Virginia, the same person’s premium would now be $297 monthly, compared with $498 before.

The premium rates in the 23 states where the federal government runs risk pools will now more closely resemble the “rates for individual policies in each state,” which, while lower than what those pools had been charging, are still prohibitive for many of the individuals who would quality for coverage.

Still, a recent report from the Commonwealth Foundation found that high premiums aren’t solely responsible for pools’ relatively low enrollment rates. “[P]eople with preexisting conditions who have been uninsured for a long time may have stopped looking” for coverage, the government has conducted limited outreach efforts (due to the relatively fast implmentation schedule), and given the multiple court challenges to reform and the media’s taste for covering negative verdicts, Americans may simply be confused about the status of the law, the report found.

The Commonwealth Fund is out with a new report examining why enrollment trends in the Affordable Care Act’s high risk insurance pools — temporary coverage programs for uninsured people who can’t find coverage in the individual market — have generally fallen below expectations. Besides the obvious structural challenges, Jean P. Hall and Janice Moore also suggest that the GOP’s efforts to repeal the law may already be undermining the high risk insurance program:

– SHORT IMPLEMENTATION PERIOD: “Given the short implementation timeline, PCIP administrators did not have ample resources available to conduct extensive outreach at the outset of the program.”

– UNINSURED HAVE STOPPED LOOKING: “[P]eople with preexisting conditions who have been uninsured for a long time may have stopped looking for insurance and may therefore be harder to reach via traditional outreach campaigns.”

– UNAFFORDABLE: “Because the PCIP coverage is based on the individual insurance market, premiums and out-of-pocket costs are generally higher than for people enrolled in group insurance plans.”

– MISCONCEPTIONS ABOUT THE LAW: “In late 2010, for example, many heated election campaigns were declaring that health reform would soon be repealed and/or replaced, or at least de-funded…. Indeed, a February 2011 poll by the Kaiser Family Foundation found that almost one-quarter of the American public believed that the Affordable Care Act had been repealed, while another quarter did not know the status of the law.”

Enrollment finally topped 20,000 in April and is expected to increase in the months ahead. Recently, the Department of Health and Human Services “announced that it would lower premiums in the 23 states where high-risk pools are operated by HHS. The remaining 27 sates run their own plans.”