So Just How Effective Was Wisconsin’s High Risk Pool In Real Life?

This letter to the editor appeared in the Milwaukee Journal Sentinel on Sunday May 21, 2017 (JSOnline) and is from someone who actually worked with Wisconsin’s high risk pool back in the day. I am going to copy it here in its entirety but you can see it at JSOnline here:

Spread the risk

In the May 15 article on high risk pools, the Journal Sentinel cited Wisconsin’s experience as a possible model (“State’s former risk pool touted”).

I was quite involved in the creation of Wisconsin’s high risk pool and served on the Board of Governors for 25 years. While I believe that Wisconsin’s Health Insurance Risk Sharing Plan (HIRSP) was very well run, it was never affordable for the many people who needed it. In spite of many efforts to contain costs, premiums and deductibles were very high. Thus, I do not believe that high risk pools are a viable model if the Affordable Care Act is to be repealed and replaced.

It is important to note who is most affected if medical underwriting is again permitted (and thus high risk pools are needed). The majority of the people in HIRSP were older, between 55 and 65. Many had chronic health conditions such as organ transplants, cancer or multiple sclerosis. Many were self-employed or small business people. They struggled to pay the premiums and out of pocket costs. I got to know several of them through a consumer advisory committee that we established.

It fundamentally does not make sense to concentrate people with known high medical needs into one plan. By definition, the cost will be very high. Instead, it makes more sense to cover such individuals by spreading the risk into much larger pools that include persons with low medical needs. This was a key part of the ACA.

Dianne Greenley

Retired Attorney

Former member, HIRSP

Board of Governors



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1 thought on “So Just How Effective Was Wisconsin’s High Risk Pool In Real Life?

  1. And this only reflects the short term consequences of the plan. In the long run, I think it would get considerably worse. Premiums would almost surely have to rise, and have to rise often, as insurers take on more and more risk. I found it interesting that most of the people in the pool were older and self-employed. My initial reaction to this issue was to help business owners see the benefit of eating the cost for insurance for higher risk team members, but it seems that wouldn’t help if most people are self-employed. This is a complicated issue, but it seems the high-risk pool is not the solution.

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