Health Experts Question Viability of Health Insurance Safety Net
Health experts are urging California lawmakers to rework the Major Risk Medical Insurance Program, arguing that demand for coverage will increase as unemployment rises and more Californians lose access to employer-sponsored health benefits, the Riverside Press-Enterprise reports.
The state-backed program serves people who are medically uninsurable by commercial plans.
The state provides less than $40 million per year for the program so enrollment is limited to 7,100 state residents.Â
Last week, 165 people were on the risk pool's waiting list, according to program statistics.
Dylan Robey, a research scientist at the UCLA Center for Health Policy Research, said the wait list can significantly decrease someone's ability to participate in the program.
Costs, Benefit Caps
In a February survey, almost 35% of enrollees who dropped out of the program said they did so because of cost.
Participants pay $450 annual deductibles. Premiums are between $8,300 and $10,080 per year, according to the Press-Enterprise.
Annual benefits are capped at $75,000 and lifetime benefits are capped at $750,000.Â
In part because of the benefit caps, the program is ineligible for federal matching funds.In the most recent legislative session, California lawmakers passed a bill that would have eliminated the annual benefit cap and required health insurers to contribute to the program, but Gov. Arnold Schwarzenegger (R) vetoed the bill (Hines, Riverside Press-Enterprise, 11/23). 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.