Some states reject high-risk insurance pools

Under the health reform law, HHS will offer a federal coverage option to uninsured people with preexisting conditions who live in states that don't participate.

By Doug Trapp — Posted May 26, 2010

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At least 19 states have declined to partner with the Dept. of Health and Human Services to create new high-risk insurance pools or to expand existing coverage programs.

The national health system reform law includes $5 billion to pay for the pools, designed to be interim coverage for people with preexisting conditions who can't obtain affordable care elsewhere. The insurance pools will begin operating July 1 and will serve as a stopgap measure until 2014, when comprehensive health insurance reforms prohibit ending or denying coverage due to preexisting conditions or health status.

Twenty-nine states and the District of Columbia said they will work with HHS to create their own high-risk insurance programs. Two states -- Utah and Kentucky -- have not indicated their final position, according to HHS spokeswoman Jessica Santillo. The new plans do not require states to provide matching funds.

The programs will cover U.S. citizens with preexisting conditions who have been uninsured for at least six months. Approximately 34 states already have high-risk pools, which cover a total of 200,000 people, according to the Kaiser Family Foundation. The health consumers group Families USA estimates that 22% of nonelderly Americans have at least one preexisting condition.

HHS will offer a federally operated high-risk pool in the 19 states that declined to participate. They are: Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia and Wyoming. Several of these states also are suing the federal government to block implementation of the health reform law.

By July 1, HHS is planning to unveil a Web portal to allow consumers to compare their options in the small group and individual health insurance markets. The site, not up at this story's deadline, also will allow consumers to check their eligibility for public programs, including the new high-risk pools, Medicaid, Medicare and the Children's Health Insurance Program. An HHS spokeswoman said information about the site's development would be posted online (link).

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