California residents who cannot obtain health insurance because of pre-existing medical conditions have a separate option for coverage through a new state pool, but potential flaws could limit the number of individuals who can enroll, the Contra Costa Times reports.
Details of the Pool
The health reform law mandates the creation of the high-risk pool, which will be offered in addition to California's existing pool for those with pre-existing conditions.
The new insurance pool will be operated using $761 million, which is part of $5 billion in federal funds set aside for similar programs across the nation.
California -- which is receiving the largest share of funds in the nation -- has the largest number of uninsured residents among all U.S. states.
About 165,000 to 396,000 uninsured individuals in California have pre-existing conditions that prevent them from obtaining health coverage or insurance that they can afford, according to data from the Insure the Uninsured Project.
In 2014, insurance companies will not be allowed to prevent individuals with pre-existing conditions from obtaining coverage.
Potential Problems
However, potential problems with California's new program might restrict the number of people who can participate.
CMS has predicted that the program could run out of money for the program by 2011 or 2012.
Rachel Arrezola -- a spokesperson for Gov. Arnold Schwarzenegger (R) -- said the state could deal with a shortfall in funding by limiting enrollment in the pool.
Premium costs will be set on the average market rate for the population as a whole.
Residents who purchase insurance through the state's existing high-risk program will not be eligible to join the new pool because participants must have lacked insurance for at least six months before enrolling.
The California HealthCare Foundation's Center for Health Reporting contributed to this report. CHCF publishes California Healthline (Bazar/Kleffman, Contra Costa Times, 10/16).