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.

Beginning July 1, a new law in South Dakota will expand the South Dakota High Risk Pool to children with preexisting conditions that may not be able to get coverage any other way.

The law will help to cover approximately 455 children that are under the age of 19 who are considered medically uninsurable.  Governor Mike Rounds explains that “Every child in South Dakota should have health insurance, and now every child can. The South Dakota High Risk Pool will begin taking applications today for children who have been without health care coverage.”

The open enrollment period is from July 1 through August 29 and allows any child who has been without health insurance coverage for 12 months or longer can enroll without a pre-existing condition waiting period. Other requirements include:

Younger than 19
U.S. citizens
South Dakota residents

Monthly premiums range from $125 to $240 a month for children who qualify for the South Dakota Risk Pool. Deductibles range from $1,000 to $10,000 a year.

Though 455 children does not seem like a lot, especially compared to the 200,000 uninsured children in the state of South Dakota, but it’s a start and South Dakota is definitely making a positive stand for uninsured children.

New Jersey’s legislation that allows single, not married children without health coverage to stay on their parents’ coverage until the age of 30 is now being followed by Pennsylvania with a bill that would extend parents’ health coverage for children up until the age of 29. Current policies only allow parents to keep their children on their health insurance up until age 19 or until they graduate college. With about 400,000 uninsured residents of Pennsylvania being between the ages of 19 and 29, this bill can help insure many people.

The economy, though it is trying to get out of a rut, is in shambles right now. Many people are losing or have lost their jobs and recent graduates are having trouble finding a full time job with health coverage. The Pennsylvania bill, which is heading to the Senate for consideration, will require health insurers to give insured parents the option of extending their coverage to an uninsured child through age 29.

To be eligible to stay on a parents’ coverage, a child must be unmarried, have no dependents, be a resident of Pennsylvania or a full-time student, and have no coverage under another health insurance policy.

“We must find a way to provide affordable coverage to young adults, both to ensure their health and to protect the overall integrity of Pennsylvania’s health-care system,” said Rep. Mark Longietti.  “My legislation offers a cost-effective way to make sure these young adults have access to health care.”

To see the full article, go to http://www.pittsburghlive.com/x/pittsburghtrib/s_627577.html