State high-risk insurance pools have high deductibles and cover far fewer people than those who qualify, according to a Government Accountability Office report.
Thirty-five states have high-risk insurance pools to provide coverage to uninsured individuals who cannot qualify for private insurance, usually because of a pre-existing medical condition.
Some 200,000 Americans are enrolled in high-risk pools, with an average age of 49 years old and an annual household income of $41,000, according to the
GAO report, which requested data from administrators of 34 such programs nationwide.
The GAO estimated that another 4 million people nationwide qualify for enrollment in a state high-risk pool.
The average annual deductible of these plans last year was nearly $1,600 -- about three times that of an average employer-sponsored plan. Average monthly premiums rose 6% between 2007 and 2008, compared with 5% among commercial plans during the same period, according to the GAO report.
Of the $56 million in federal grants to the pools in 2006, 55% of those funds were used to cover operational losses and 17% to reduce premiums, according to the report.
U.S. Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee, requested the GAO study. Some lawmakers have proposed beefing up state high-risk insurance pools as part of healthcare reform.
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