High-Risk Pool Programs Take a Step Forward

Update: We are gratified by the response we have seen from the states this important provision of the Affordable Care Act and look forward to working together to get people who have been denied coverage for so long, access to some much needed relief through the creation of temporary high-risk pools. Whether states create these pools or the federal government creates them for states, the pools will be paid for by 100 percent federal dollars and mostly importantly – uninsured people around the country will soon have access to another affordable coverage option.

We value the input of our state partners and are heartened by the strong show of support we have seen already for getting the critical benefits of the Affordable Care Act to the American people as quickly as possible.  This is a very   state-friendly law that is designed to give states important resources and flexibility to implement the new law.

We will work closely with the states in the coming weeks and months to help their residents who have been denied coverage to finally have affordable options.

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Right now, in 45 states across the country, insurance companies can discriminate against people based on their pre-existing conditions – leaving many Americans unable to get health insurance.

The Affordable Care Act creates a high-risk pool program to help adults who are uninsured and have a pre-existing condition get insurance as soon as possible.  The program is a bridge to the health insurance exchanges that will be available in 2014.

Earlier this month, Secretary Sebelius sent a letter to states asking how each would like to participate in the high-risk pool program.  The program was designed to give states the flexibility to carry out their own program, or have HHS do it for them.  Specifically, states can:

• Operate a new high risk pool alongside a current state high risk pool;
• Establish a new high risk pool (in a state that does not currently have a high risk 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.

As a former Governor and State Insurance Commissioner, Secretary Sebelius understands the important role that states have in improving the health security of American families.  Over the past several weeks, HHS has held several briefing calls and has been working individually with states to explain how the program will work and the different options for carrying out.  Yesterday alone, over 350 people representing all 50 states, and Washington, D.C. participated in a call with HHS about implementation and the new high-risk pool program.

So far, 43 states have told HHS how they would like to participate; 28 have indicated they would like to run a high risk pool program, and 15 have said they would prefer that HHS administer the program for their residents. 

Regardless of whether or how a state participates, the bottom line is that all Americans who meet the eligibility criteria will have the opportunity to join a high risk pool program.

More information on the high-risk pool can be found here.

Here’s a list of what states have decided as of 4:15 p.m. today:

States that intend to operate their own high-risk pool program:

Alaska
Arkansas
California
Colorado
Connecticut
District of Columbia
Illinois
Kansas
Kentucky
Maine
Maryland
Massachusetts
Michigan
Missouri
Montana
New Hampshire
New Jersey
New Mexico
New York
North Carolina
Ohio
Oklahoma
Pennsylvania
Rhode Island
South Dakota
Vermont
Washington State
Wisconsin

States that have elected to have HHS run the high-risk pool program:

Alabama
Delaware
Georgia
Hawaii
Idaho
Indiana
Louisiana
Minnesota
Mississippi
Nebraska
Nevada
South Carolina
Tennessee
Wyoming
Virginia