Before passage of the ACA, dozens of states operated high-risk pools designed to cover individuals whose preexisting conditions rendered them uninsurable. As Republicans are thinking now about a replacement for the ACA, they say that such separate insurance pools could be part of the answer. Critics say these programs have not worked well in the past, because putting all the sick people in one pool drives up costs and premiums, causing some states to experience heavy losses. As a result, some states imposed long waiting times for entry to the pools or limited how much care would be paid for in any given year.
To try to keep the state pools stable, Price has proposed $1 billion a year in federal subsidies for three years — less than the ACA devoted to a temporary high risk pool before the marketplaces opened. The temporary program ran out of money. Skeptical Democrats say much more money and regulation would be needed to make high risk pools viable.