Many states to form new high-risk insurance pools

The health insurance reform bill passed in March included a program to help states form new insurance pools to cover people with pre-existing conditions until 2014. April 30 was the deadline for states to inform the federal Department of Health and Human Services whether they planned to participate. As of Friday afternoon, officials in 28 states had announced plans to create new high-risk pools, while officials in at least 15 states (listed here) had declined to participate for fear that federal funds may be insufficient to cover the operation of these pools until 2014.

Here are more details about the program:

Consumers will be eligible for the new pools if they have a pre-existing medical condition and have not had insurance for at least six months.

They will pay premiums that parallel rates being offered by commercial insurers to healthy people on the individual market. Many existing high-risk pools charge such high premiums that many people cannot afford the coverage. Today, high-risk pools in 34 states cover only about 200,000 people.

Individuals who sign up for the new pools also will not have to pay more than $5,950 a year out of their pockets for medical care, according to the legislation.

In Iowa, Democratic Governor Chet Culver hailed the new pools as a step toward giving uninsured people access to affordable coverage. Experts from the Iowa Policy Project have estimated that the new high-risk pool could serve more than ten times the number of people enrolled in Iowa's current high-risk pool, which has operated since 1987.

CORRECTION: Although the Iowa Policy Project estimated that more than 30,000 Iowans might be eligible for the new program, the Des Moines Register quoted HIPIOWA Executive Director Cecil Bykerk and State Senator Jack Hatch as saying federal funding will allow only about 1,000 people to be covered in the new high-risk pool before 2014.

All three Republican candidates for Iowa governor oppose our state's participation in the new federal program. The Des Moines Register quoted Rod Roberts directly and spokesmen for Terry Branstad and Bob Vander Plaats. I don't know how quickly the new pool will be up and running, but I'd like to see the Republican nominee for governor explain to Iowans with pre-existing conditions why they should have to go without affordable insurance coverage until 2014. If I were Culver's campaign manager, I'd consider running ads on this issue in the fall.

Share any relevant thoughts in this thread.

Tags: health insurance reform, health care reform, high-risk pools (all tags)



Breath, Held

It's somewhat amusing that the link to the "details" on states amounts to a story written from the exact opposite end - not who is starting a pool, but how many states are not. That story, I think, gets it closer: this is a mixed bag event, at best, and it's dangerous to get too far ahead of what hasn't happened yet. Unti there's an actual pool, and we have a sense of what premiums actually will be, there isn't a product available to the uninsured. And it's then an open question of what care they will be available to access.

There's a reason insurers have been avoiding preexisting conditions: most obviously, it's because the costs associated with someone who needs care, possibly lots of care, can be an expensive prospect. This is why "cost of care" has been so crucial to actual reform, and why the lack of it is so serious a flaw in the "reform" package we now have. "High risk pools", even subsidized ones, will face enormous costs of care for the people they insure; that can be spread into premiums, but it will make a costly product, or the government can cover the shortfalls... but just speaking of New York, never mind Californis, I'm hard pressed to see how a massive new subsidy can possibly be added to a state budget already facing enormous cuts and few real opportunities for additiobnal revenue. The money, really, just isn't there.

As I said, we'll see how this plays out; in the short run, it seems clear that uninsured "high risk" individuals can't count on anything being available until next year (six months to develop the pool means Novemeber, at the earliest, and most states mght as well kick the thing into the next calendar year at that point), so it's not as if speed seems to be the order of the day here. I think many political candidates will, arguably, run away from this as a campaign issue: you either look slow to act, or callous by saying that it can't, feasibly, be done; and those who campaign for it will be on the hook to explain, at some point, all the challenges that come as a result. Many, I think, will wait to see who goes first, what the premiums look like, and how many people sign on. And all of that, I think, won't tell us much for about a year and a half at the earliest.

by nycweboy1 2010-05-01 12:18PM | 0 recs
RE: Breath, Held

I hear what you're saying, but more states are forming the new pools than not forming them--including some very populous states like New York and California.

Yes, it's going to be costly, which is why the federal government set aside $5 billion to help states operate the pools.

by desmoinesdem 2010-05-02 08:19AM | 0 recs
RE: Breath, Held

Costly because the states, in their drive to save capitalist medicine, are willing to take the risk load off of the medical insurance companies to ensure that they continue to remain ultra profitable, salvage exuberant CEO salaries, and continue the doubling of cost compared to government run or controlled medical systems overseas.

The only possible way around this state enhanced profiteering is for the wise states to begin their own single payer government run systems ala Medicare.

by MainStreet 2010-05-02 02:31PM | 0 recs


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