A key feature of John McCain's health care proposal is the "high risk pools" for the uninsurable—people who don't get insurance on the job and can't buy a policy on their own because they have a pre-existing medical condition. Similar pools operate in 35 states, with varying degrees of success.

Kevin Sack in today's New York Times reports that the high risk pools "have served more as a stopgap than a solution." The article goes on to note that:

Though high-risk pools have existed for three decades, they cover only 207,000 people in a country with 47 million uninsured...Premiums typically are high, as much as twice the standard rate in some states, but are still not nearly enough to pay claims. That has left states to cover about 40 percent of the cost, usually through assessments on insurance premiums that are often passed on to consumers.

Some states impose waiting periods, and others limit the number of enrollees. High risk pools do not help people who can get insurance, but not specific benefits they need because of their health history.

McCain's advisers earlier cited a $7 to $10 billion annual cost of the pool, which critics say wouldn't go very far given that the states now spend $2 billion to cover 207,000. But more recently McCain's team said they haven't worked out the financial details, which will be a challenge given that McCain has pledged to balance the budget in his first term.