Tuesday, July 13, 2010

Speaking of Pools (ObamaPools©, that is)

Why, you might ask, are we spending so much time on the so-called "high risk pools" for folks who've had difficulty obtaining insurance on their own? The reason is quite simple: the pools are exemplars of how ObamaCare© will ultimately work (or not work). The premise was that there are millions upon millions of people who couldn't qualify for and/or afford health insurance on the open market because the evil, greedy, incompetent insurance companies were being difficult.

So what's the solution?

A government-instituted plan that is every bit as difficult to obtain, and likely even more expensive than that which it's ostensibly to replace. You may wonder, how can I say this with a straight face?


This morning's email brought a missive from Medical Mutual of Ohio, the insurer tasked with implementing the Buckeye State's new ObamaPool©. Here are the requirements for eligibility:

Be a citizen or national of the U.S. or lawfully present in the U.S. (documentation will be required) [Really? Have we moved to Arizona now?]

Be uninsured for six months prior to application date. [Hence: folks who will now drop their current coverage in order to jump in the pool]

Be ineligible for coverage under the federal Medicare program, Medicaid program, [SCHIP] or an employer-sponsored group health plan, unless the individual is subject to a mandatory initial waiting period. [Essentially expanding the Medicaid rolls]

Have a qualifying pre-existing condition as evidenced by a denial of coverage by two insurers or by documentation from a health professional. [More hoops through which to jump]

I'll just pick on that last item: in order to qualify, one must now apply to, and be denied by, two separate carriers. Imagine now that hundreds, perhaps thousands of new applications begin flooding the carriers still in the Ohio market which are being sent in specifically to be denied. Carriers, already short-staffed, will have to give these the same attention as legitimate applications, thereby holding up coverage for folks who actually applied in good faith. How many of these will grow disgusted and throw in the towel? And would that be considered by ObamaCare© proponents as a bug or a feature?

Perhaps they'll go the alternate route, and now hundreds, perhaps thousands of new patients will be flooding doctor's offices specifically to determine whether or not hey have a qualifying medical condition. What kind of strain is that going to put on an already shrinking provider population? And who's going to pay for that?

This is a microcosm of how ill-conceived ObamaCare© really is. But remember, we had to "pass it to learn what's in it."
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