Health and Human Services Secretary Kathleen Sebelius warned that Republican proposals to help those with preexisting conditions by setting up high risk insurance pools were bound to fail in a “death spiral” that forces insurers to periodically raise prices to cover increasing costs brought about by the fact that only the sickest people will choose to buy such expensive policies.

“You will always have the highest costs and, on top of that, the highest costs, and you’ve got the sickest people who are already paying the highest costs for treatment. They don't work very well,” she said.