There will not be enough money available to support the states in launching the new reform law's high-risk insurance pools, Rep. Michael Burgess (R-Texas), chairman of the Congressional Health Care Caucus, said during a briefing sponsored by Health Affairs in Washington.
Funds lacking for high-risk pools: lawmaker
The White House this week is expected to announce an ambitious high-risk insurance pools program, which will offer special coverage for uninsured people with medical problems.
“We have a situation where we'll have $5 billion put into these risk pools,” said the Texas physician, who's also a member of the House Energy and Commerce Committee. States aren't required to set them up, but many may decide not to do so, considering how “woefully underfunded” these programs are, even in states with existing high-risk pools, he said.
Burgess admits these programs have value, “but my suspicion is the funding level is the biggest problem.”
“No one really knows what the correct answer is for funding. I can tell you it's not $5 billion.” That sum will be spent relatively quickly, “and that's why the states are reluctant to jump into this.” In their view, they'll be left holding the proverbial bag if the funding runs out, he said.
“And then HHS will be obligated to constrain enrollment either through waiting lists, or rationing,” Burgess predicted.
A better solution would be to work with states that have existing funding pools “and provide, if necessary, some additional federal assistance in the form of a direct subsidy or premium cap,” he said. A bill he had introduced, providing $20 billion in funding for these programs, “would have done just that.”
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.