The lessons of high-risk pools

THE LESSONS OF HIGH-RISK POOLS…. Nine months after the Affordable Care Act became law, all kinds of provisions have already taken effect. Some appear to be working better than others.

On the positive front, small businesses that couldn’t afford to cover their employees are now starting to offer affordable insurance in much stronger numbers, thanks to small-business tax breaks offered by the ACA. Because small-business employees tend to be the most likely to go without coverage, progress on this front is very encouraging.

Less encouraging, though, are reports that high-risk pools, intended to help those with pre-existing conditions get coverage right away before more systemic reforms kick in later, aren’t working nearly as well. The costs tend to be too high, and those eligible often don’t hear about the option.

National Review, not surprisingly, is seizing on this as evidence of flaws with “Obamacare.” But that’s an overly-narrow look at the larger policy dynamic. After all, the very idea for high-risk pools comes from — you guessed it — congressional Republicans. Indeed, go back and check out the McCain/Palin health care plan from 2008, and you’ll notice this was one of the centerpieces.

Jon Chait noted seven fairly recent items from the pages of National Review, each of which endorsed the same high-risk pools that were included in the Democratic plan, and which aren’t proving to be effective. Jon concluded:

Liberal health care wonks insisted that high risk pools tended to work very badly and were at best a stopgap solution. Democrats included some expanded high risk pools as a carryover, they-can’t-hurt palliative until the full reform goes online. Obviously, they haven’t done much good. But that hardly tells you that “Obamacare” has failed.

Under the circumstances, doesn’t it seem more appropriate for Republicans to explain why one of their signature health care ideas has come up short?