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The Public Policy

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THE FINAL COMPONENT would be state uninsurable risk pools. Over half the states already have such pools, and they have worked extremely well. Those who do not have health coverage and then become uninsurable because of contracted illnesses would obtain coverage from the risk pool in their state. The state would charge slightly above market premiums for this coverage, to guard against unnecessary use of the pools, with the vouchers available to help low and moderate income workers foot the bill. But such premiums would still not be enough to finance health care for these sick uninsurable individuals. So the state would subsidize the pool to cover remaining costs. This has proved to be a relatively minor cost in the states that have such pools

Very few people actually become uninsurable. So the risk pool enables them to be covered without exploding costs and exploding big government for everyone else. The block grant funds from the Medicaid and SCHIP programs could be used by the states to pay for these risk pools.

That's it. With these health policy reforms, everyone has somewhere to go to get essential health care when they need it. Those who have health insurance are assured of keeping it with guaranteed renewability. Those who are too poor to buy health insurance would receive assistance to assure they could buy at least a basic, essential plan. Those who nevertheless do not become covered and then become too sick to get coverage would receive essential health care through the state uninsurable risk pool.

Through the block grants for Medicaid and SCHIP government overall would become smaller. Yet a basic safety net demanded by the public would be established to assure that no one ever has to do without essential health care.

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