NASE News

Federal Government, States Working To Implement High-Risk Pools

In one of the first of many deadlines associated with the new health care reform law, states had until the end of April 2010 to inform the Department of Health and Human Services (HHS) of their decision to establish a high-risk insurance pool.

Seventeen states have said they will allow the federal government to establish its own high-risk pools in their states, while 29 states and the District of Columbia have said they will create their own pools using federal funding. Florida and Arizona have yet to respond to HHS about their decision despite the passage of the deadline, while Rhode Island and Utah have requested applications and additional information, and have indicated they will make decisions later.

The high-risk pool program has $5 billion in funding and is a temporary measure until 2014, when insurance companies will be prohibited from discriminating against people with pre-existing conditions. The pools must be in place by this summer to help adults with pre-existing conditions buy insurance coverage, as insurance coverage for these individuals is often prohibitively expensive.

“We…look forward to working together to provide people who have been denied coverage for so long, access to some much needed relief through the creation of temporary high-risk pools,” said HHS spokeswoman Jenny Backus in a statement. “Whether states create these pools or the federal government creates them for states, the pools will be paid for by 100 percent federal dollars and most importantly – uninsured people around the country will soon have access to another affordable coverage option.”

The department had assumed that some states, especially smaller states that could benefit from having their residents in a larger federal pool that spreads the risk among more people, would choose to allow the federal government to establish pools. However, some states that turned down the opportunity to create their own pools cited concerns that the $5 billion HHS had set aside for the pools wouldn’t be enough and the states would have to cover the rest of the cost. HHS told state officials in a recent conference call that they wouldn’t let this happen.

Alaska, Arkansas, California, Colorado, Connecticut, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Montana, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Vermont, Washington, West Virginia, Wisconsin and the District of Columbia have chosen to run their own programs.

HHS will run programs in Alabama, Delaware, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia and Wyoming.