Sometimes I wonder if Sen. Joni Ernst considers ignorance to be analogous to a military decoration. Or if she would prefer natural selection to be a cure to society’s ills.
When it comes to her approach to health care, it’s easy to reach this conclusion, especially when she supports retrograde “solutions” that have no evidentiary basis, such as state-managed high-risk pools that are supported by a sprinkle of federal funds, as an alternative to universal coverage.
Being consistent with a philosophy that punishes the weak, high-risk pools would shift and exponentially increase the financial burden to those who choose to enroll in the program. Indeed, before the enactment of the Affordable Care Act, state-administered high-risk pools charged premiums as much as 250 percent higher than rates for healthy individuals in the individual insurance market.
Moreover, premium revenues, on average, paid for only 53 percent of program costs, and deductibles were as high as $25,000, while coverage limits were as low as $75,000. For the uninsured with pre-existing conditions, this creates an untenable situation because 80 percent have income below 400 percent of the poverty line.
So in addition to pricing the most vulnerable out of the marketplace, the result will be a higher level of forgone or delayed care and a greater incidence of adverse health outcomes, which will lead to substantial regressions that are systemically felt, such as putting us back on a trend toward health care costs that exceed 20 percent of GDP. Call it the paradox of selfishness.