The high-risk insurance pools created under the new health reform law could cost the federal government as much as $15 billion if the current $5 billion spending cap is removed, according to a letter released on Monday by the Congressional Budget Office. CBO Director Douglas Elmendorf wrote the letter, which reiterated a previous CBO report finding that the $5 billion allocated for the program would not be enough to cover the costs of all applicants through 2013.