Some States To Launch High-Risk Insurance Pools This Week
Beginning Thursday, U.S. residents who have been denied insurance coverage because of pre-existing medical conditions will be able to apply for coverage in several states' new, temporary high-risk insurance pools, the New York Times reports.
The pools were created under the national health reform law, which mandated that states must enact their own pools or allow the federal government to administer a pool for them until 2014, when the reform law requires insurers to accept all applicants. The overhaul stipulated that the pools be established within 90 days of its enactment, a deadline that passed last Monday.
So far, 20 states have chosen to allow the federal government to operate the pools. The other 30 states have told the federal government that they plan to administer their own pools.
Of those states, about 20 have filed formal proposals with the federal government for funding. Federal officials say funding approval may come as early as Thursday, with coverage set to begin in August (Pear, New York Times, 6/25). The remaining 10 states continue to work through legislative and other issues and might be weeks or months away from submitting proposals.
In California, the Legislature still needs to approve two bills giving the state the power to run the high-risk pool, Jeanie Esajian, spokesperson for the state's insurance program, said.
Esajian said, "Our plan, if everything goes smoothly, is to begin taking enrollment in August and be open for business in September" (Young, USA Today, 6/27).
Funding for High-Risk Pools
Congress approved $5 billion to aid states in establishing the pools. However, multiple sources, including the Congressional Budget Office, have estimated that the funding might run out prior to 2014 (Konrad, New York Times, 6/24).
HHS Secretary Kathleen Sebelius has warned states not to let spending exceed funding for the program and several state officials have said they would freeze enrollment if needed to stay on budget.
The pools are expected to provide coverage to between 200,000 and 400,000 U.S. residents (New York Times, 6/25). Only people who have lacked coverage for at least six months will be eligible for the pools (New York Times, 6/24).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.