| There are circumstances
when an individual without access to group coverage cannot
obtain health insurance because he is a medical high risk
or already has a chronic health condition. Fortunately, the
fraction of non-elderly uninsured persons who are not institutionalized
and who would be rated as actuarially uninsurable is generally
estimated to be very small, less than 1 percent of the population.
(Mark Pauly, Health Affairs)
In addition, there are individuals who have
an illness, but still can obtain a policy. However, it may
come with a higher premium, exclusions, or waiting periods.
For those who have adequate income, this is not a problem,
but for those with modest or low incomes, these restrictions
may present a significant barrier for coverage. Studies show
that most people applying for coverage in the individual market
are offered coverage (88%), and 71% are offered coverage at
standard rates. A small number are rated up (5.9%) and 14%
are issued coverage with riders. Only 3% are offered coverage
with both riders and extra premiums.
Regardless of the number, people who are
sick, uninsured, and unable to secure health insurance should
have help. CAHC members support the creation of state high-risk
pools to provide insurance to those in this situation. Not
only will they be able to get coverage, but also the cost
of coverage in the high-risk pool is limited, making it more
affordable. This should help reduce the uninsured.
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