Terms Defined: High Risk Pools

High risk pools were actually around for about ten to fifteen years prior to the ACA. They were available in the majority of the states. But when President Obama’s healthcare law went into effect, high risk pools went away. However, as the new administration works on reforming the healthcare system, the idea of high risk pools is resurfacing. They want to bring risk pools back. By bringing them back, they’re hoping to lower the overall health insurance rates in each state and make insurance affordable again.

What Are High Risk Pools?

High risk pools are for those who have health conditions that prevent them from being covered under a regular health plan. To clarify, some have what is called pre-existing conditions, meaning their health problems occurred prior to having a health insurance policy. If their condition is bad enough, then they may be disqualified and excluded from coverage. This is where high risk pools come in. Since not everyone qualified for traditional health insurance, high risk pools offered a way for people with major health problems to get coverage.

Essentially, the risk pools take on the unhealthy people. As a result, it doesn’t affect everybody else as far as health plans and costs are concerned. Prior to the Affordable Care Act (ACA), those with no major health issues could get plans 50-60% less than the risk pool. So, healthy individuals could access affordable health plans while those with health issues could receive the coverage they need.

Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  So if you have any questions or concerns, comment below and your question may be the topic of our next video!

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