Congressional Republicans say they plan to dismantle health care reform by denying funds for its various programs.
But there's one program created by the new law that Senate Republicans have championed: the interim-high risk pool, formally known as the Pre-Existing Condition Insurance Plan. In June, Senate Republicans sent a letter to Health Secretary Kathleen Sebelius chiding the administration for missing a startup deadline and for failing to provide more than $5 billion.
"The $5 billion meant to protect those with pre-existing conditions will run out long before 2013 and up to $10 billion in additional funding will be needed for the millions of Americans that need this coverage," said Sen. Mike Enzi (R-Wyo.) in a statement accompanying the letter.
"Given the importance of the high risk pool program and the reliance on this program of millions of Americans with pre-existing conditions and life-threatening diseases, it is crucial that this program be fixed and fully funded," Enzi continued. "I am disturbed by the Administration's failure to fund this program and my colleagues and I want answers about when this assistance will be provided and how much it will take to actually provide the coverage promised."
In the fall, Democrats touted the high-risk pool as one of the few parts of health care reform to take effect almost immediately, but since then they haven't said much about it. The pool is designed to provide insurance to people who are uninsurable on the private market because of pre-existing conditions until 2014, when insurance companies will no longer be able to discriminate against the sick. The PCIP offers slightly cheaper premiums than high risk pools currently available in 35 states, which cover 200,000 people and often exclude coverage for some conditions.
Since its launch in July, the PCIP has reached only a few thousand people, and many states have capped enrollment. The program's administrators in the federal government expect it to reach only 350,000. There are as many as four million people uninsured because of pre-existing conditions.
The Congressional Budget Office estimated (PDF) that with unlimited funding the PCIP would insure only 700,000 through 2013 at a cost of $15 billion.
High-risk pools are the centerpiece of the House GOP's alternative health care bill, funded with $25 billion over the next ten years, roughly $4 billion per year once the program is fully phased-in.
"We are committed to repealing ObamaCare and replacing it with common-sense reforms that lower cost, including our high-risk pool proposal, which is superior to the one in Washington Democrats' law," said a spokesman for House Republican leader Rep. John Boehner (Ohio) in an email to HuffPost.
Health care wonks have been skeptical of the idea. "An effective high-risk pool would be more than a small add-on filling a few gaps in the existing insurance system. The program would serve millions of people, spending tens of billions of dollars annually," wrote the University of Chicago's Harold Pollack back in March. "Yet it would bring no guarantee that participants would truly be protected against crushing financial burdens. In presenting high-risk pools as a viable alternative to comprehensive reform, Republicans would leave tens of millions of Americans uninsured, including millions of people with serious health conditions we know would be healthier and would probably live longer if we provided them with basic health coverage."