Amendment Sets Aside Billions to Subsidize High-Risk Patients

Members of the House Rules Committee stayed behind after other lawmakers left for their two week recess to devise an amendment that sets aside $15 billion to allow states to reimburse health insurance companies for covering their more-ill customers.

“This amendment alone is real progress, and it will help us build momentum toward delivering on our pledge to the country, House Speaker Paul Ryan said of the Palmer-Schweikert amendment this week, reports The Washington Examiner. 

The amendment, named for Reps. Gary Palmer, R-Alaska and David Schweikert, R-Arizona, the two Freedom Caucus members who sponsored it, solves the problem of delivering lower premiums while still allowing people with pre-existing conditions to have access to insurance coverage, supporters say.

The new subsidies could also help keep higher-risk patients from driving up other customers’ premium costs. The conservative Foundation for Government Accountability, which supports the measure, said they also expect it will lower the numbers of people without insurance coverage.

The amendment, however, does not specify who will be determined as high-cost risks, but requires that the Department of Health and Human Services develop a program with states, insurance companies, and consumers to determine which ailments are driving up costs.

The measure is considered an “invisible plan,” with applicants for healthcare filling out a statement, and if they qualify, funds are allocated for their care. The enrollees would know know themselves if they meet the standards for the coverage, and once claims meet a certain threshold, the fund will kick in. Once that happens, the insurers would be reimbursed at Medicare rates.

A similar plan was put in place in 2011 in Maine, allowing premiums to be cut in half. In that state, customers’ plans were priced with the assumption that everyone was healthy, with people with high risks obtaining more subsidies. Under more traditional plans, all recipients are priced as if they are already ill, a report from The Foundation for Government Accountability states.

Source: newsmax – Amendment Sets Aside Billions to Subsidize High-Risk Patients

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