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GAO: Risk Pool Claims Vary

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The cost of insuring people who have a hard time qualifying for conventional health coverage varies widely from state to state.

Analysts at the U.S. Government Accountability Office have published state-by-state data on claims costs for individual high-risk pool participants in a risk pool report prepared for Democratic leaders of the House Energy and Commerce Committee, and the committee’s health subcommittee.

The report was sent to the congressional leaders in July and released to the public today.

State risk pool programs provide health coverage for residents who are unable to buy conventional, medically underwritten coverage, as a result of past or current health problems.

One table shows that the average claims cost for risk pool participants increased to $9,437 in 2008, from $6,795 in 2003.

At the state level, the average 2008 risk pool claims cost ranged from a low of $4,109 in West Virginia to a high of $16,252 in Washington State.

The average 2008 monthly premium for a West Virginia risk pool member was $585, and the average 2008 monthly premium for a Washington state risk pool member was $538.

The 34 risk pools enrolled 199,418 people in 2008, GAO analysts write.

“We estimate nearly 4 million additional individuals to be potentially eligible for enrollment in an HRP based on their uninsured status and preexisting health conditions,” the analysts write.

A copy of the full report is available here.