Eliminating the Affordable Care Act and placing sick people into state-based high-risk pools would drive up state spending, deny coverage to many more people, and result in plans that do not meet the medical needs of the people who need it most.

That's according to Carolyn Long Engelhard, director of the Health Policy Program at the University of Virginia School of Medicine's Department of Public Health Sciences. Engelhard writes in The Hill that House Speaker Paul Ryan's advocacy of the triage of people with serious medical issues into high-risk pools would bring about some of the very problems he claims it would solve.

Sick people in an average insurance pool use more medical services, thus driving up the cost of coverage for everyone in that pool and causing at least some of the healthiest to drop out. That in turn drives up the cost further, causing less healthy people to drop out because they cannot afford the premiums and resulting in a very small number of people with coverage and very high costs for the people who remain.

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