Sunday, September 28, 2008

Would Sara Palin Be Able to Buy Health Insurance Under McCain's Plan?

The answer is probably not. Health insurance companies stay as far away as possible from a family with a child with Down syndrome. According to the National Down Syndrome Congress:

The whole issue of access to health insurance places an extraordinary burden on families and persons with Down syndrome and other disabilities. Families and adults with Down syndrome are forced to consider issues of obtaining or maintaining health insurance coverage above career and other significant life decisions. Even when they are able to access health insurance coverage, the financial cost can be exorbitant.
Of course in the short-run, Palin is fortunate to have group coverage as a public employee in Alaska. Over time under the McCain proposal, however, such employer provided plans would fall apart as low-risk participants abandoned the plans to get nongroup coverage, leaving only high-risk, high-cost people in the group plan. Eventually, employers--including the Alaskan government--would kill their plans. Although there is much uncertainty as to how fast this process would take place, and the McCain campaign has intentionally obfuscated the issue, there is no doubt that the long-term vision is to eliminate employer-provided health coverage.

So what would a family with a Down syndrome child do in McCainland, when forced to fend for itself on the “nongroup” insurance market? In principle, the family would have to look for insurance from a state-based high-risk pool. Here's what the Health Affairs article on the McCain plan said about this idea:
High-risk pools can be helpful as a way to cover some of the very sick. But to make more than a small dent in reducing the number of uninsured people, high-risk pools would need to be well funded. Senator McCain has proposed spending $7-$10 billion to subsidize high-risk pools--not nearly enough to make them work to cover significant numbers of the uninsured....

State high-risk pools under Senator McCain's plan are likely to go the way that current high-risk pools have gone. Currently, thirty-four states sponsor such pools, but they cover fewer than 200,000 Americans. Because money is scarce, states deliberately restrict benefits and keep enrollment low. For example, Florida's high-risk pool has been closed to new enrollees since 1991. California has rationed access to its pool by limiting the amount of time enrollees can be covered through the program and by capping enrollment. As a result, a sizable number of consumers who are too healthy to qualify for coverage through a high-risk pool will be deemed "high risk" by nongroup insurers and will face very high premiums, restricted benefits, and, in some cases, outright denials of coverage.
This is the essential problem with the McCain plan. It would kill the current system of employer-provided group coverage, leaving many people with preexisting conditions unable to buy insurance on the private market. If Palin ever does another interview after her disastrous encounter with Katie Couric, this would be a good question for her: "How would a family like yours, with a child with a disability, be able to buy nongroup coverage under the McCain-Palin health care proposal?"


Richard H. Serlin said...

Great post. It may be a good idea for Biden to bring this up in the vice-presidential debate.

Don Pedro said...

I actually think that would be a bad idea. Journalists seem to think that the rule is that you can't mention your opponent's children, although of course you are free to talk about your own all you want, so I think they would judge it a gaffe if he made any mention of the fact that she has a child with Down syndrome.