Healthcare Business News

Sebelius queries governors on high-risk pools

By Rebecca Vesely
Posted: April 2, 2010 - 3:15 pm ET

In a first step toward providing coverage to uninsured people who have pre-existing medical conditions, HHS Secretary Kathleen Sebelius has sent a letter to governors in each state gauging their interest in participating in a temporary high-risk pool.

The new health reform law appropriates $5 billion in federal funds to create short-term mechanisms to cover the uninsured who cannot qualify for insurance on the open market because of prior medical conditions. These high-risk pools will be in existence until 2014, when insurers will be barred from denying coverage to people with pre-existing conditions.

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States have several options. They can set up their own high-risk pool, build on existing programs or do nothing, in which case the HHS would provide a coverage program in that state. Thirty-four states have high-risk pools already, with a total of about 200,000 participants, according to the Kaiser Family Foundation.

“The purpose of this letter is to begin that conversation about which of these options works best for them,” Sebelius said on a conference call with reporters.

Governors and independent state insurance commissioners have until April 30 to respond to the letter. Coverage for this group of uninsured is expected to be in place by late June, and members will pay standard monthly premiums similar to those on the individual market, HHS officials said. It's unclear how many people will qualify.

Members must be U.S. citizens who have been uninsured for at least six months.

Some Republican governors have said they plan to sue the federal government to block the health reform law's implementation. But officials at the HHS said they hope the governors will cooperate with this new program.

“We, to date, have not heard any resistance,” said Jeanne Lambrew, deputy director of the White House Office of Health Reform. “We anticipate we will get a lot of interest.”

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