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Why High Risk Pools (Still) Won't Work
Many proposals to repeal and replace the Affordable Care Act rely on high-risk health insurance pools to cover people with preexisting conditions.
As the new Congress convenes and the Supreme Court prepares to hear arguments in the King v. Burwell case challenging tax subsidies for insurance purchased through the federally facilitated marketplaces, proposals to repeal and replace the Affordable Care Act (ACA) are resurfacing. Many of these rely on high-risk health insurance pools to cover people with preexisting health conditions.
In fact, the risk pools are suggested as a viable alternative to the ACA's ban on preexisting condition exclusions in the individual market and the marketplaces. My recent analysis of high-risk pools, however, explains why these entities simply are not a realistic alternative to coverage requirements under the ACA.
Read the full blog post at The Commonwealth Fund: http://bit.ly/1B6Jlzs
Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections
September 17th 2025Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
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AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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Infertility Coverage Boosts ART Use and Pregnancy Success: Richard A. Brook, MS, MBA
August 26th 2025In this episode, Richard A. Brook, MS, MBA, discusses his study showing that infertility treatment coverage increases assisted reproductive technology (ART) use and improves pregnancy outcomes.
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