Responding to Ed's response to Item #6 above, regarding high-risk pools,
35 states ALREADY HAVE NON-PROFIT, STATE-INDUSTRY RUN
HIGH RISK HEALTH INSURANCE POOLS!! I wrote about this yesterday on the other thread about Affordable Care Act:
Since 1976, these high-risk health insurance pools are for people who cannot get private insurance because of pre-existing conditions, or for having exhausted lifetime limits, etc. etc.!!!!
"Since the first state high-risk health insurance plans were established in Connecticut and Minnesota in 1976, risk pools have grown in number and have evolved in their role in addressing inequities and inadequacies of the health care system.
Today, risk pools are accepted, proven programs that serve special needs, and contribute an element of stability in key individual markets of the insurance system.
Health insurance risk pools serve two primary roles-- they provide a means for guaranteed access to insurance, that enables individuals to protect themselves from catastrophic medical bills; and they are increasingly recognized for the role they play in helping to keep the individual insurance markets viable for companies to continue to compete in.
About Pools
Health insurance risk pools are special programs created by state legislatures to provide a safety net for the "medically uninsurable" population. These are people who have been denied health insurance coverage because of a pre-existing health condition, or who can only access private coverage that is restricted or has extremely high rates.
Each of the state risk pool-type programs is different.
Generally, the programs operate as a state-created nonprofit association overseen by a board of directors made up of industry, consumer and state insurance department representatives. The board contracts with an established insurance company to collect premiums and pay claims and administer the program on a day-to-day basis.
Insurance benefits vary, but risk pools typically offer benefits that are comparable to basic private market plans -- 80/20 major medical and outpatient coverage, a choice of deductible and co-payments. Maximum lifetime benefits vary by state from as low as $350,000 to $2 million."
Read more:
About Pools
See States with High-Risk Pools:
States with Pools
See State-by-State Analysis in 2010 in free report sections here:
***Especially see "Claims as a Percent of Premium", and "Sources of Funding" 2010, to see the premium to claims ratio (claims paid out exceed premiums received in almost all states), and how in most states, ASSESSMENTS on insurance companies balance that ratio and pool funding!
SEE:
Quick Checks
Also see Minnesota's High-Risk Health Insurance Pool's website to see the specifics of their plan on which many others were modeled:
MCHA's Home Page - 866-894-8053