State-run high-risk pools can provide coverage for the up-to-4-million uninsured Americans with expensive preexisting conditions, and they can do so for $15 to $20 billion a year — compared to ObamaCare’s cost, from 2018 onward, of over $200 billion a year. Furthermore, ObamaCare’s alternative solution of requiring insurers in the regular market to cover people with preexisting conditions at regular premiums, would likely cause a “death spiral”: everyone else’s premiums would rise as a result; many younger and healthier people would respond by dropping their insurance and paying the fine (knowing they could sign back up as necessary); premiums would therefore rise further; more healthy people would drop out; etc. But high-risk pools have to be well-designed, unlike the pools that will start this year under ObamaCare (long before most of the overhaul), which are very poorly designed and will be very poorly funded (receiving less than $2 billion a year, or less than 1 percent of what ObamaCare would soon cost), and hence are doomed — if not designed — to fail.
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