Cruz has an idea for how to cover high-risk patients

The health care bill that passed the House a few months ago called for Americans with a history of serious illnesses to be covered in their own, special highrisk insurance pool.

When the Senate unveiled its health legislation in June, it notably omitted the unpopular provision, instead requiring that all Americans be covered by the same kind of insurance, and be charged the same price as other customers of the same age.

Now Sen. Ted Cruz of Texas has an idea that could bring back the high-risk pool.

His proposal, which he’s circulating to his colleagues on typed handouts, wouldn’t explicitly create and fund the special insurance markets, as the House bill did. Instead, insurance experts said, it would create a sort of de facto high risk pool, by encouraging customers with health problems to buy insurance in one market and those without illnesses to buy it in another.

Senate leaders are taking the proposal seriously, as it offers something for conservative and moderate lawmakers, at least on paper. And, according to a Fox News interview with Marc Short, the White House director of legislative affairs, the Congressional Budget Office is evaluating the plan this week.

There is no public legislative language yet, but here’s how Cruz’s plan appears to work, based on his handout and statements: Any company that wanted to sell health insurance would be required to offer one plan that adhered to all the Obamacare rules, including its requirement that every customer be charged the same price. People would be eligible for government subsidies to help buy such plans, up to a certain level of income. But the companies would also be free to offer any other type of insurance they wanted, freed from Obamacare’s rules.

People who bought the Obamacare-compliant plans would be eligible for subsidies that limit their cost, as long as their income was less than about $42,000 per year for a single person. And those who earn more — or wish to buy skimpier, cheaper plans without all the rules — may also get a discount on those premiums, in the form of pretax health savings accounts, which the legislation would let them use to buy insurance.