ObamaCare’s pre-existing problems need a pragmatic fix

The Obama Administration recently suspended enrollment in the law’s not surprisingly over-budget federal high-risk pool program. But a new bill, the “Helping Sick Americans Now Act” sponsored by Rep. Joe Pitts (PA-16), would reset ObamaCare’s priorities, by reallocating $4 billion of ObamaCare spending to the law’s high-risk pool and simultaneously reducing the federal deficit by $1 billion. It may not be the high-risk pool we would have architected or think is optimal long term. But among ObamaCare spending, Congress should make this program a priority.

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Alleviating the plight of people with pre-existing conditions was one of ObamaCare’s most effective selling points. Most Americans have friends or a family member who faces extremely high health insurance premiums or difficulties obtaining insurance coverage because of an illness or other medical condition that requires ongoing treatment. ObamaCare promised to help this group, in part by creating a federal high-risk pool – the “Pre-existing Condition Insurance PLAN" or PCIP.

This federal high-risk pool had some design flaws: People with serious pre-existing conditions couldn’t qualify until they went six months without insurance. Rep. Pitts’ bill would remove this onerous requirement.

If the design of this program was bad, the implementation has been even worse. Costs have been disappointingly high, and enrollment disappointingly low. In fact, by the time 107,000 Americans had signed up—that’s far below the 600,000 to 700,000 that the Congressional Budget Office expected—the program’s money had run out. The Administration shouldn’t be surprised that PCIP faces a budget crunch: The CBO warned that $5 billion would fall woefully short.

The PCIP is far from the only part of ObamaCare that has faced serious setbacks. The 1099 provision and the CLASS Act have been repealed. No part of the law has come in under budget, and rarely has the Department of Health and Human Services met an implementation deadline. The poor implementation of this comprehensive law has drawn bipartisan fire.

Helping those with pre-existing conditions, however, is one area where ObamaCare at least try to deliver. Now that ObamaCare is law, the Obama Administration is no longer pretending to care about the sickest Americans. Although Secretary Sebelius has the authority to move funds into this program, she hasn’t, instead using her so-called “Prevention and Public Health Fund” (known as the Prevention Fund, or Slush Fund) to bankroll various activities without oversight.

This sends the message to the 40,000 people with pre-existing conditions who want to enroll in the program that they aren’t the real priority now that they are no longer politically useful. Instead, the “Prevention” fund has financed such apparently higher priorities such as pet neutering campaigns, bike/park signs, and gardening, and more disturbingly lobbying campaigns to advance liberal causes such as enacting fast food construction moratoriums and higher soda taxes; now it is being used for liberal activist groups to promote enrollment and pour money down the exchange rat hole.

The Helping Sick Americans Now Act would require HHS to transfer approximately $4 billion in FY 2013-2016 funding from the slush fund and reallocate part of it to helping sick people the President has turned his back on. The remainder, about $1 billion, goes to deficit reduction. To be clear: this bill defunds ObamaCare. Contrary to some headlines and conservative activist groups, this does not “add” money to ObamaCare, nor “fix” nor support it. This legislation would not only help sick Americans obtain insurance, but also eliminate four years of funding from an ObamaCare program rife with waste and abuse, instead directing those dollars to where they will do no harm, and may do some actual good.

ObamaCare was really never about helping people about with pre-existing conditions; it was an entire reordering of our health system to put government more in charge. Compare the $5 billion spent on the PCIP to the law’s total 10-year costs, an estimated $1.76 trillion. The PCIP is established in Section 1101 of the law, a whopping 8 pages out of the law’s total 2407. But many Americans didn’t realize that, and supported the law because of their concern for others like those with pre-existing conditions.

The best policy would be to fully repeal ObamaCare and go back to the drawing board, so that we can create a better system to help those with pre-existing conditions, while also bringing down health care costs, encouraging medical innovation, and improving access to care.

It would be much better if we could avoid spending any money at all on the further implementation of a poorly designed law. But this isn’t a realistic option in the immediate term, which means Congress should instead move forward with the Helping Sick Americans Now Act.

ObamaCare’s PCIP is not perfect. But to oppose this bill is to allow those funds to implement other aspects of the law which are changing our health care system in ways the people never intended while neglecting those it was intended to help.

Heath is a policy analyst at Independent Women’s Voice. Higgins is the group’s president and chief executive officer.