The debate about HRP, pre-x, insurablilty apply mainly to the individual market (not employed, self-employed etc)
If anything I'd expect the incidence of 'uninsurables' to be at least as high in the individual market as in the general population
Many of those in the general population are in the workforce, and obtain benefits from the employer, pre-x and all. Large groups generally have the characteristic mandate called "guaranteed issue" they may well have most of those "pre-existing conditions" but as far as the carriers are concerned, if they are healthy enough to work, they are healthy enough to insure.
Using that same logic, those not employed, and seeking coverage in the individual market may well be uninsurable.
There's a way around this for the carriers. In Maine, we have a 12 month "preexisting condition exclusion".
Title 24-A: MAINE INSURANCE CODE
Chapter 36: CONTINUITY OF HEALTH INSURANCE COVERAGE
§2850-A
B. "Preexisting condition exclusion," with respect to coverage, means a limitation or exclusion of benefits relating to a condition based on the fact or perception that the condition was present, or that the person was at particularized risk of developing the condition, before the date of enrollment for coverage, whether or not any medical advice, diagnosis, care or treatment was recommended or received before that date. [2001, c. 258, Pt. E, §9 (NEW).] [ 2001, c. 258, Pt. E, §9 (RPR) .]
2. Limitation. An individual, group or blanket contract issued by an insurer may not impose a preexisting condition exclusion except as provided in this subsection. A preexisting condition exclusion may not exceed 12 months from the date of enrollment, including the waiting period, if any. For purposes of this subsection, "waiting period" includes any period between the time a substantially complete application for an individual or small group health plan is filed and the time the coverage takes effect.
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In other words, they are insurable except for the pre-x, unless it's nothing serious, they can then be fully covered, to be decided by the carrier.
Another thing getting lost in the fray is the deliberate confusion of terms in that they are trying to cross-identify those with a minor pre-x, with those uninsurables who have an incurable or terminal illnesses.
Even so, should someone be enrolled in an HRP and later be deemed insurable (cured, condition goes away or is maintained with medication etc) they can continue to apply for regular coverage until they qualify.
Also, this whole debate pretty much applies to first time individual market applicants. Otherwise, carriers generally tend to honor each other's pre-x exclusions.
Sounds similar to the ERISA requirements for group plans.
Otherwise, carriers generally tend to honor each other's pre-x exclusions.
In the group market because they have to. In the individual market? No way in hell (pre-ACA).