In the "first real test" for federal officials as they implement the new reform law, state health officials are required by Friday to inform HHS whether they wish to join a program that creates high-risk health insurance pools to provide coverage for people with pre-existing conditions, Politico reports (Haberkorn, Politico, 4/27).
The new reform law stipulated that the high-risk pool program must be established within 90 days of the overhaul's enactment, which is June 21. States that decide to join the program could create or expand their existing pools, or they could transfer the responsibility to the federal government.
More than 30 states already have such pools in operation. States also can choose to opt out of the program, which expires on Jan. 1, 2014, when the new law requires private insurers to accept all applicants regardless of pre-existing health issues (California Healthline, 3/30). The law allocates $5 billion for the program.
Early indications suggest that implementing the program is going to "at best a bumpy road," Politico reports (Politico, 4/27).
California
The Assembly Health Committee has approved a bill (AB 1887) by Assembly member Mike Villines (R-Clovis) that would establish a high-risk insurance pool for individuals who are unable to obtain private coverage because of a pre-existing condition.
California already has a high-risk insurance pool that covers about 7,000 residents, but it does not meet requirements to qualify for federal subsidies under the new health reform law.
The high-risk pool proposed under AB 1887 would operate along with the state's current pool until 2014, when insurance companies will be prohibited from denying coverage based on pre-existing conditions (California Healthline, 4/21).
Other States
Earlier this month, Georgia Insurance Commissioner John Oxendine (R) announced that his state would opt out of the program, citing concerns that the $5 billion reserved for the program is insufficient and that the state eventually would have to absorb the costs of administrating it.
On Monday, Louisiana Insurance Commissioner James Donelon (R) said he and Gov. Bobby Jindal (R) have made a preliminary decision to opt out of the program. Donelan said the decision was based on cost factors, adding that the state "[cannot] afford this."
Politico reports that Kansas insurance officials also have similar concerns about cost and eligibility, among other factors. Linda Shepphard, director of the accident and health division at the Kansas Insurance Department, said that "there were a whole lot of questions and not a lot of answers."
Richard Cauchi, health program director at the National Conference of State Legislatures, said that the agency promised that states would not be expected to pay for the program.
Cauchi, who participated in a recent conference call with HHS and state health officials about the program, said the some state officials expressed concern that residents also could have unrealistic expectations for the rest of the plan.
He said, "They don't want to be making a false or unknown promise to an unknown number of residents that as of July 1, we're going to be taking care of your health insurance," adding, "Why put yourself out there as the savior of health coverage if you can't fulfill it?" (Politico, 4/27).