Thursday, May 5, 2011

$2.6 Trillion to Cover…18,000 Sick Enrollees?

Testifying before the House Education and the Workforce Committee this morning, Secretary Sebelius indicated the Department would be releasing a report with updated enrollment figures for its high-risk pool program tomorrow.  She testified that the report would show that the $5 billion program has now enrolled a total of 18,000 participants with pre-existing conditions.

While the Administration is trumpeting the increase in enrollment over the last several months, it’s worth putting these figures in context.  First, according to the most recent estimates from the National Association of State Comprehensive Health Insurance Plans, two existing state high-risk pools (Texas and Minnesota) each have more enrollees than the entire new federal program; several other states (including Illinois, Wisconsin, and Maryland) have nearly as many enrollees as the 18,000 participants in the federal plan.

Second, keep in mind that the health care law spent $2.6 trillion in its first full decade of implementation, largely to ensure that all individuals would have access to coverage.  But the Administration has enrolled only 18,000 individuals with pre-existing conditions into the high-risk pool.  At this rate and based on these metrics – $2.6 trillion in spending, and 18,000 participants – the federal government will spend $14.4 million per year for every person with pre-existing conditions newly enrolled in coverage.  That’s not just enough money to buy each person with pre-existing conditions a platinum-plated insurance policy – that’s practically enough to buy each one a small hospital.

To be sure, Republicans support high-risk pools as a way to ensure individuals with pre-existing conditions have access to coverage.  Unfortunately, the Democrat plan that was enacted contained crucial design flaws that may serve to limit enrollment.  However, the HHS update on this program shows that – no matter how it’s structured – America did not need to spend $2.6 trillion to cover individuals with pre-existing conditions who need access to care.