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Recent health reform proposals would allow insurance companies in the individual market to—once again—consider people’s health when deciding whether to sell them coverage. Individuals denied coverage because of a pre-existing condition would likely rely on high-risk pools to access health insurance. In their latest report, PPI’s Lynda Flowers and Claire Noel-Miller describe high-risk pools and highlight their limitations: they were very expensive, they tended to charge high premiums and deductibles, they typically offered limited coverage, and they were not adequately funded—resulting in very low enrollment.