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Sebelius Checks With States On Risk Pools

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The U.S. Department of Health and Human Services Secretary has sent letters to governors and state insurance commissioners asking about their interest in participating in the temporary high risk pool program created by the new health insurance reform law.

“The establishment of a temporary new high risk pool program is one of our first tasks in implementing the new health reform law and will help provide affordable insurance for Americans who have been locked out of the insurance market for too long,” says HHS Secretary Kathleen Sebelius in her letter. “This letter marks the first step in that process and demonstrates one of our core principles of implementation: building on effective programs that already exist. In the coming days, we will work closely with states to answer their questions.”

The health reform legislation established the temporary high risk pool program to help provide coverage to people who are uninsured because of preexisting conditions. States may choose whether and how they participate in the program. Sebelius says HHS will work closely with states as the program is put into practice.

“We are interested in building upon existing state programs in this important initiative to provide expanded access to health coverage for individuals who cannot otherwise obtain health insurance,” Sebelius states. “To that end, I am writing you today to request an expression of your state’s interest in participating in this temporary high risk pool program, consistent with one of the implementation options.”

The new health insurance reform law provides $5 billion in federal funds to support the new program.

Among the options available to states that participate:

–Operate a new high risk pool alongside a current state high risk pool;

–Establish a new high risk pool in states that does not currently have such a pool;

–Build upon other existing coverage programs designed to cover high-risk individuals;

–Contract with a current HIPAA carrier of last resort or other carrier to provide subsidized coverage for the eligible population; or

–Do nothing, in which case HHS would carry out a coverage program in the state.


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