Temporary high-risk insurance pools, which Republicans want to make a permanent alternative to the upcoming health insurance mandate, have enrolled only a small fraction of the people they were expected to enroll, according to a report by the New York Times.
The new risk pools were set up this year to cover patients with high-cost pre-existing conditions, such as cancer, who leave hospitals and other providers stuck with huge unpaid bills. Such patients cannot find insurance coverage unless they are part of employer groups.
House Republicans' recent "Pledge to America" reiterated the GOP's call for high-risk pools in place of the health law's ban against insurers rejecting applicants with pre-existing conditions, which will go into effect with the insurance mandate in 2014.
The new state-run pools, set up by the reform law to function until the ban goes into effect, were expected to enroll 375,000 people this year, but a new HHS report said the pools have enrolled just 8,000 people so far. The report said pools in 21 states have enrolled fewer than 50 people each, and even New York and Florida have enrolled fewer than 300 each.
Prior to the HHS report, many experts worried that spending limits for the risk pools would force them to turn applicants away.
Possible explanations for the low enrollment include lack of awareness, a requirement that applicants be uninsured for at least six months and premiums that can be unaffordable, even though they are set at market rates and have caps on out-of-pocket costs.
HHS hopes to stir up more interest in the pools next year by providing consumers choices of plans with different costs and deductibles, but this change would not address the cost of the insurance.
Nineteen states have refused to set up state-based risk pool, citing lack of funds, but in these cases the federal government has set up risk pools for the states, using federal funds available to all states.
Read the New York Times report on risk pools.
Read other coverage on risk pools and pre-existing conditions.
- Citing Pre-Existing Conditions, Large Health Insurers Denied Coverage to 651,000 Applicants in Individual Market
- 19 States Refuse to Create High-Risk Pools Despite $5B in Federal Funding
- GOP Senate Candidate Opposing Preexisting Conditions Provision in Reform Law
The new risk pools were set up this year to cover patients with high-cost pre-existing conditions, such as cancer, who leave hospitals and other providers stuck with huge unpaid bills. Such patients cannot find insurance coverage unless they are part of employer groups.
House Republicans' recent "Pledge to America" reiterated the GOP's call for high-risk pools in place of the health law's ban against insurers rejecting applicants with pre-existing conditions, which will go into effect with the insurance mandate in 2014.
The new state-run pools, set up by the reform law to function until the ban goes into effect, were expected to enroll 375,000 people this year, but a new HHS report said the pools have enrolled just 8,000 people so far. The report said pools in 21 states have enrolled fewer than 50 people each, and even New York and Florida have enrolled fewer than 300 each.
Prior to the HHS report, many experts worried that spending limits for the risk pools would force them to turn applicants away.
Possible explanations for the low enrollment include lack of awareness, a requirement that applicants be uninsured for at least six months and premiums that can be unaffordable, even though they are set at market rates and have caps on out-of-pocket costs.
HHS hopes to stir up more interest in the pools next year by providing consumers choices of plans with different costs and deductibles, but this change would not address the cost of the insurance.
Nineteen states have refused to set up state-based risk pool, citing lack of funds, but in these cases the federal government has set up risk pools for the states, using federal funds available to all states.
Read the New York Times report on risk pools.
Read other coverage on risk pools and pre-existing conditions.
- Citing Pre-Existing Conditions, Large Health Insurers Denied Coverage to 651,000 Applicants in Individual Market
- 19 States Refuse to Create High-Risk Pools Despite $5B in Federal Funding
- GOP Senate Candidate Opposing Preexisting Conditions Provision in Reform Law