“It doesn’t seem like it’s near enough money,” said Douglas Holtz-Eakin, who was a top domestic policy adviser for McCain. The McCain campaign ultimately concluded it could take as much as $20 billion a year to properly run risk pools, he said. The White House says McCain’s proposal was more elaborate and not directly comparable to “The Great One’s”.
If the Democrats’ risk pool starts running out of money, the government may have to start a waiting list, raise premiums or take other unpopular measures. Congress could be asked for a bailout.
Several independent experts say concerns about the financing are valid. “It would seem that ($5 billion) is going to be small relative to the need,” said Thomas Buchmueller, a University of Michigan business professor.
Some 30 states now have risk pools for those who can’t get health insurance on the private market, covering about 200,000 people at a cost of around $1 billion a year. “This is clearly not going to be enough money to cover everybody,” said Pollitz. Insurance expert John Bertko, a visiting scholar at the Brookings Institution, said it may be possible to stretch the $5 billion, but there’s a small margin for error.
Bertko said his “back of the envelope” math suggests there are about 1 million uninsured Americans in poor health, or five times the number currently covered by state high-risk pools. If all of them signed up for the new federal pool, it would burn through the $5 billion in a year. However, people eligible for government benefits often fail to sign up. And if only one-third were to enroll, the budget could work.
That’s cutting it close. “No doubt about that,” said Bertko.