GOP amendment would give $15 billion to insurers to cover high-cost patients

GOP amendment would give $15 billion to insurers to cover high-cost patients
© Greg Nash

An amendment to the GOP's repeal plan would dole out $15 billion to insurers over nine years to help cover the costs of sick, expensive patients. 

Lawmakers say the new funds would bring down premiums for healthy people by subsidizing medical costs for people with especially high expenses. 

Under ObamaCare, insurers are required to charge everyone of the same age the same amount for premiums, regardless of their medical history or conditions. 


That means costs are spread out among healthy and sick people, with insurers essentially passing those costs on to healthy people. 

The $15 billion would help subsidize the costs of expensive patients, but the amendment doesn't lay out how the money would be distributed. Instead, it leaves distribution up to the Health and Human Services department. 

In 2020, the administration of the program will be handed over to the states. 

"I believe what we've written here helps us mitigate their need to stay in the healthcare system but also mitigates the extra costs that have been transferred to other folks trying to buy healthcare coverage," said Rep. David SchweikertDavid SchweikertEthics Committee releases new details on allegations against Arizona GOP lawmaker GOP lawmakers call for provisions barring DOD funds for border wall to be dropped Bipartisan resolution aims to protect lawmakers amid heightened threats of violence MORE (R-Ariz.), one of the sponsors of the amendment. 

The idea, modeled after a program in Maine, appears similar to the “reinsurance” idea from the first three years of ObamaCare.

That program gave insurers $7.9 billion for 2014 and $7.8 billion for 2015. 

But experts say $15 billion is not enough to bring down premiums. 

"$15 billion over 9 years is definitely not enough to make a meaningful difference in premiums or market stability," tweeted Larry Levitt, senior vice president of the Kaiser Family Foundation. 

The House Rules Committee approved the amendment 9-2 Thursday.