An argument against Paul Ryan's high-risk pool proposal

House Speaker Paul Ryan and his fellow Republicans are correct in some of their criticisms of the Affordable Care Act, but their idea to switch back to risk segmentation through state-based high-risk pools is not a workable solution, argues Carolyn Long Engelhard, director of the Health Policy Program at the University of Virginia School of Medicine's Department of Public Health Sciences. In a post for The Hill, she acknowledges that the ACA's individual mandate has not been enough to draw more young, healthy enrollees into the risk pool, making the cost of insurance still too high for many. Yet publicly funded high-risk pools are not new, and in the past have resulted in high administrative costs, unaffordable premiums and skimpy benefits, she says. Opinion piece