California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Few California Residents Enrolling in High-Risk Health Insurance Pool

Although 250,000 California residents qualify for coverage through a high-risk health insurance pool established under the federal health reform law, just 1,588 individuals have enrolled, the San Diego Union-Tribune reports (Lavelle, San Diego Union-Tribune, 3/16).

Details of High-Risk Pools

In July 2010, HHS launched the Pre-Existing Condition Insurance Plan to provide coverage to individuals with pre-existing conditions. Washington, D.C., and more than two dozen states opted to launch their own pools, while more than 20 others states deferred to HHS to run the program.

In April 2010, federal officials estimated that about 375,000 residents nationwide would gain coverage through the high-risk pools. By November 2010, only 8,011 people had enrolled in the pools, and by mid-January 2011, the enrollment count had edged up slightly to about 10,000, according to HHS officials (California Healthline, 2/11).

The program is designed to serve as a bridge until 2014, when the federal health reform law prohibits health plans from denying coverage based on pre-existing conditions.

California has received  $761 million in federal funding to operate the high-risk pool. Part of that money goes toward subsidizing the costs of premiums, which vary by age and county.

Reasons Behind Low Enrollment

Health care advocates say that low enrollment figures could be the result of:

  • Premiums that are too steep;
  • A requirement that individuals seeking coverage through the pool be uninsured for six months; and
  • Low awareness about the pool (San Diego Union-Tribune, 3/16).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.