Prior to 2014, high-risk pool plans provided coverage to individuals who had been denied insurance because of health issues. They placed people with similar medical needs in one pool.
Since 2014, the Affordable Care Act has required that all health policies be guaranteed issue (meaning no one can be denied for health conditions). If the Affordable Care Act is repealed, high-risk pool plans might be revisited as a method of keeping insurance within reach of people who may not qualify.
The tradeoff: these plans were often twice as expensive as the average plan and had more limited options. Out-of-pocket costs were high, and most had a limit on the amount they paid in a lifetime.
Funding high-risk pools was tricky too. With all the sickest people in one pool, the cost per person was higher than the premiums paid. So they were usually funded by state governments. With the Affordable Care Act still in effect, the premiums paid by healthy people help cover the cost of the bills for those who are sick.
Reminder: Open Enrollment for 2022 health insurance is from Nov. 1, 2021 - Jan. 15, 2022 (with extensions in some states). If you’re in the market for new health insurance coverage, call the friendly licensed agents at Mylo for the most up-to-date plans! We look forward to helping you out, even if you just want advice.