Posted on : June 25, 2010 | By : Mona Lisa Vito | In : Reform
Today is the deadline for states to submit details to the Department of Health and Human Services on how they intend to operate the high-risk health insurance pools mandated by healthcare reform. The high-risk pool program is intended to provide coverage to those who have been denied health insurance because of a pre-existing condition and who have been without coverage for more than six months. These pools are meant to bridge the gap for such individuals until subsidies and new health insurance exchanges are instituted in 2014. Other crucial reforms included in the package which brought on these pools are provisions that allow individuals to stay on their families’ insurance plans up to age twenty-six, prevent insurers from excluding children because of preexisting conditions, and eliminate lifetime limits on health costs imposed on policyholders. Twenty-nine state and the District of Columbia have elected to run their own pools and will be entitled to a portion of the $5 billion allocated by the federal government to fund them. Nineteen states said they would leave operation of pools in their states to the federal government. Some think tank analysts and state officials worry that federal funding may run out, leaving states liable to cover these high-risk patients out of their own budgets. Federal officials at the Department of Health and Human Services have assured these doubters that the funds will last for until 2014 in states where it will administer the pools. They further say the federal government will cover the costs of developing or modifying accounting or enrollment systems and any other start-up costs states may incur. The contracts due to Health and Human Services today must include strategies for operation of the pools, estimations of total cost, and other provisions. Enrollment in the pools begins July 1 and coverage for policyholders will begin August 1. For more information on the high-risk pools in your state, contact your state’s Department of Insurance.