Expanding Individual Health Insurance Coverage: Are High-Risk Pools the Answer?

In principle, high-risk pools are a brilliant solution to a serious dilemma: They would solve a pressing social problem, guaranteeing access to adequate coverage while allowing the private health insurance market to operate relatively unencumbered by “social†regulation. Subsidies would ensure that they are affordable to individuals not eligible for public coverage, and their cost would be distributed broadly to minimize burden. In practice, however, high-risk pools often fall well short of this mark. They typically mirror the individual health insurance market’s problems of access, affordability, and benefit adequacy, and they offer more costly and less complete coverage than many policymakers might imagine. Although 30 states operate high-risk pools, only a few have found success, this critical appraisal finds.