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Obamacare: Helping the Sick Means Getting the Policy Right

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On February 15, the Centers for Medicare and Medicaid Services (CMS) announced it was suspending future enrollment in its Pre-existing Condition Insurance Plan (PCIP) for lack of funds. This week, the House of Representatives is planning to vote on a bill that would transfer $4 billion from the Obamacare Prevention and Public Health Fund (“Prevention Fund”) to reopen the Obamacare federal high-risk-pool program.

Supporters argue that reopening the Obamacare federal high-risk pool would “help the sick” while stopping the Administration from using the Prevention Fund as a slush fund for other Administration priorities. But the larger question is whether these Obamacare federal high-risk pools are worth an additional investment and expansion.

Obamacare established the PCIP to provide temporary access to coverage for those uninsured who are denied coverage due to pre-existing conditions. The law appropriated $5 billion to fund the program until 2014, when the remaining Obamacare insurance regulations relating to pre-existing conditions take effect.

The CMS originally projected that 375,000 people would seek coverage through the PCIP, and Obamacare appropriated $5 billion to support them. However, only 110,000 have enrolled, and yet the $5 billion is already maxed out. Even the Administration conceded that PCIP experienced claims costs 2.5 times higher than they anticipated.

By no means does this mean that Congress should ignore the barriers facing those with pre-existing conditions or the misuse of funding in the Prevention Fund. But there are better policies to address these issues.

For the Prevention Fund, obviously the best solution would be to simply rescind the funds in the program. If the Administration is considering using the Prevention Fund as a slush fund, then the intended purpose of the fund is obviously not a priority.

For those with pre-existing conditions, certainly high-risk pools should play a role, but the real solutions are broader than high-risk pools and are in sharp contrast to the extreme policies rooted in Obamacare.

The goals of the proposal may be laudable, but the policies are not. At the very least, it would be wise for Congress to address the underlying policy flaws—including possibly directing more control to the states—before dumping billions more taxpayer dollars into a program that appears to fall short of its stated goals.

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