Enrollment in High-Risk Insurance Pools Off to Slow Start Nationwide
Only about 3,600 people have applied and about 1,200 have been approved for coverage in state-based, high-risk health insurance pools since they were created about six weeks ago, according to preliminary data from states and the federal government, Kaiser Health News/NPR reports (Galewitz, Kaiser Health News/NPR, 8/19).
Under the federal health reform law, HHS on July 1 launched the Pre-Existing Condition Insurance Plan that establishes the high-risk pools until 2014, when private insurers are required to accept all applicants regardless of pre-existing conditions (California Healthline, 7/20).
Washington, D.C., and 28 states opted to launch their own pools, while 22 states deferred to HHS to run the pools.
As of Aug. 13, a total of 2,400 people had applied for the 22 pools administered by the federal government, according to HHS data. HHS declined to release specific numbers for the states, citing the "fluid" nature of the information.
Application numbers in states that chose to establish their own pools have varied greatly since July 1, including:
- 400 in Oregon;
- 100 in Montana;
- 12 in New Hampshire; and
- One in Connecticut.
The Congressional Budget Office estimated that as many as four million uninsured U.S. residents would qualify for the pools and that 200,000 would be enrolled by 2013.
Three Likely Reasons for Low Interest
Officials and observers say there are several likely factors for the low interest in the high-risk pools, such as:
- Unaffordable premiums: Although the program is subsidized by $5 billion in federal funding and the premiums are less costly than those of existing high-risk health insurance programs, they still are unaffordable for some individuals. Premium rates vary among states and depend on the age of applicants and whether they are smokers.
- Strict eligibility criteria: Prospective applicants must have been uninsured for at least six months and have a pre-existing condition. They must provide evidence that their application for coverage through a private insurer was rejected and that they were denied certain benefits because of a pre-existing health condition. In about a dozen states, applicants have the option of presenting a note from a physician indicating that they have a pre-existing condition.
- Insufficient publicity: Some state officials say there has not been enough time to develop promotional and marketing campaigns for their pools.
Officials noted that it is too soon to gauge the program's success because it is not scheduled to be fully operational in all states until next month (Kaiser Health News/NPR, 8/19).
Illinois To Accept Applications Today for Pool That Launches Sept. 1
In related news, the office of Illinois Gov. Pat Quinn (D) on Thursday announced that state residents with pre-existing conditions who have faced difficulty obtaining coverage through private insurers can begin applying to the state's new high-risk pool on Friday, Chicago Business reports. The plan will be administered as a PPO with a $2,000 deductible (Colias, Chicago Business, 8/19).
Enrollment in the Illinois Pre-Existing Condition Insurance Plan will proceed on a first-come, first-served basis, and approved applicants will start receiving their benefits on Sept. 1.
The state will administer the pool with $196 million from the federal government and premium dollars from enrollees. State officials expect the program will cover about 5,000 of the estimated 1.7 million uninsured state residents (Graham, Chicago Tribune, 8/19).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.