States opt in or out of health pools

[Htown Harry]

This week, we reached one of the first milestones of the new federal health care act - a deadline for the states to tell HHS whether or not they would be setting up their own high-risk pools.

http://www.kff.org/healthreform/upload/8066.pdf

On April 2, 2010, U.S. Department of Health and Human Services Secretary Kathleen Sebelius issued a letter that gives states the following options for operating the temporary high-risk pool:

(1) Operate a new high-risk pool alongside an existing state high-risk pool;

(2) Establish a new high-risk pool if the state does not currently have one;

(3) Build upon other existing coverage programs designed to cover high-risk individuals;

(4) Contract with current HIPAA insurance carriers or insurers of last resort to provide subsidized coverage; or

(5) Do nothing, in which case the U.S. Department of Health and Human Services would carry out the coverage program in the state.

The Secretary’s letter asked states to submit a letter of intent regarding which option they will pursue by April 30, 2010.

For states opting out, the feds will establish a temporary national high-risk pool to provide health coverage to individuals with pre-existing medical conditions. (Until 2014, when the state exchanges go into effect and health insurance companies no longer would be allowed to deny coverage to people in poor health.)

Which choices were available to your state?

Which option did your state choose?

What was their justification for the choice?

Will this have an effect on E-R for you?

My state Texas, has a high risk pool already and was choosing among #3, #4 and #5.

To no one's surprise, Gov. Perry chose option #5. (We're one of the states whose AG's are challenging the new health care law).

The justification was financial risk:

"As we've seen in federal education and stimulus programs, the administration is again asking states to commit to a program without knowing the rules of engagement," Perry stated in a letter to HHS Secretary Kathleen Sebelius.


"I do not believe that the aggressive implementation and the lack of assurances on financial solvency of the program are in the best interest of Texas taxpayers, families, patients or health care providers."

Fortunately, lacking pre-existing conditions, I don't have a dog in this particular hunt. My E-R schedule and strategies are unchanged.

[REWahoo]

Quote:

Originally Posted by Htown Harry Fortunately, lacking pre-existing conditions, I don't have a dog in this particular hunt.

Be happy you don't have a coyote in it either...

[Martha]

Minnesota is keeping its current risk pool and opting out of the federal pool. Minnesota's pool is unequivocally the best in the nation. It was the right decision. I am in the pool.

The biggest problem with the risk pools until 2014 are the barriers to entry. For example, if you are not HIPAA eligible you may (under the fed plan and under a number of state plans) have to go without insurance for six months before you can get into a pool.

[W2R]

According to the list in this article , Louisiana has chosed option #5 and has elected to have the U.S. Department of Health and Human Services run our high risk pool program.

I believe Louisiana is still one of those states contesting the constitutionality of the new health changes. So, it makes sense that we would be doing nothing.

(Some might say it makes sense for Louisiana to do nothing as a general practice... )

[Martha]

The article cited by W2R is confusing because it says that Minnesota has elected to have the feds run their pool. But that is not correct, Minnesota has opted out of the fed program and will continue to run its own. Pawlenty opts out of federal high-risk insurance pool for Minnesota - TwinCities.com

[MichaelB]

A summary here, although I'm not confident this is the final word.
Some Republican States Opting Out Of High Risk Health Insurance Pools - Kaiser Health News

Quote:

CQ HealthBeat: "As of 12:30 p.m. Friday, these are the states that will operate a program: Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Illinois, Kansas, Kentucky, Maine, Maryland, Michigan, Missouri, Montana, New Jersey, North Carolina, Ohio, Oklahoma, Rhode Island, South Dakota, Vermont and Washington. States opting out are Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, Tennessee and Wyoming" (Norman, 4/30).