A misfire from the circular firing squad

An early ObamaCare program already is running out of money, and the president has decided to close it to new enrollment, leaving tens of thousands of people who were expecting help out in the cold. 

The House of Representatives is expected to vote next week on legislation that would extend this safety net, and it would do so with money that HHS Secretary Kathleen is using as a slush fund to implement the law. 

The Helping Sick Americans Now Act (H.R. 1549) is a win-win.  Providing insurance to people with pre-existing conditions was a key motivator for passage of ObamaCare in the first place. The House leadership is correct in proposing legislation to continue this coverage.   

If, as seems increasingly likely, implementation of the Exchanges will have to be delayed because of the coming “train wreck,” as Senate Finance Chairman Max Baucus (D-MT) warns, then allowing the pre-existing condition pool to accept applicants will make delay more feasible.  

ObamaCare initially allocated $5 billion for the Pre-Existing Condition Insurance Plan (PCIP) designed to provide temporary bridge coverage for those most needing help until the health law takes full effect in 2014. 

But the Obama administration has closed enrollment, saying it needs the money that remains to cover the medical costs through the end of the year of the 100,000 people already enrolled. 

And the costs are significant:  The average cost per enrollee in 2012 was $32,108 a year.  But the costs varied widely by state, from a low of $4,276 per enrollee to a high of $171,909. Some patients have annual claims as high as $225,000 per person. 

But the bill, which passed the Energy and Commerce Committee on Wednesday 27 to 20, is causing considerable consternation and division among conservatives, and a circular firing squad has formed. 

The Club for Growth, for example, is urging House members to vote “No.”  Others say that supporting the pre-existing condition funding is enabling ObamaCare.   

“This proposal would further extend the federal government’s role in healthcare,” the Club argues. “Because this bill eliminates a previous requirement for enrollees to be uninsured for six months, it creates the moral hazard of avoiding insurance until it is needed and provides an extra incentive for people to enroll in federally-run insurance. 

“Furthermore, this bill does nothing to lower healthcare costs, which should always be the goal of any health reform proposal.”  The Club then goes on to describe a series of market-based health reforms which have zero chance of passage in the current political environment.  This is a political misfire. 

One of the biggest – but highly inaccurate — criticisms of Republicans is that they don’t have a plan to fix the very real problems in the health sector.  But the high-risk pools have been part of the House leadership’s reform plan since before ObamaCare was enacted.  And high-risk pools are designed to hold down the cost of private insurance by removing the most expensive people from the pool.  

This safety net makes sense politically.  It is offering a solution that helps vulnerable people.  It redirects existing ObamaCare spending to actually helping sick people. It reduces the deficit.  And it should be able to garner bi-partisan support. 

If conservatives would get out of their circular firing squad, we might be able to make some progress here. 

An estimated 4,000 people are enrolling in the program every month.  That means that an estimated 40,000 people needing coverage will be turned away before the end of the year. “With your support, we could help these Americans get the care they need,” the leaders wrote in an earlier letter to President Obama seeking his support for the initiative. 

No word yet from the White House. But the president’s hand would certainly be called if the measure were to reach his desk.  Help sick people, or not?  What will it be?   

The Helping Sick Americans Now Act would transfer approximately $4 billion from the Prevention and Public Health Fund to PCIP to continue the coverage. In addition to eliminating the Obamacare implementation slush fund, the bill is expected to cut the deficit. 

The legislation is sponsored by Health Subcommittee Chairman Joe Pitts (R-PA) and Vice Chairman Michael C. Burgess, M.D. (R-TX), along with Rep. Ann Wagner (R-MO). “In the context of health reform, helping those with pre-existing conditions obtain health insurance has been one of the few areas of agreement between Republicans and Democrats over the last several years,” Chairman Pitts said.  

Health Subcommittee Vice Chairman Dr. Michael C. Burgess (R-TX), added, “House Republicans have urged the president to work with us on a solution to this issue, yet he has remained silent. Today we have a solution. I applaud this committee’s action to correct the administration’s failure to follow-up on their promises to the American people.”