HHS Greatly Relaxes High-Risk Pool Eligibility Requirements to Boost Enrollment

email shareprint

HHS Greatly Relaxes High-Risk Pool Eligibility Requirements to Boost Enrollment

Tuesday, May 31st, 2011 - 22:15
Tuesday, May 31, 2011 - 21:51
HHS gets rid of the most difficult eligibility requirement for entry into federally run high risk pools.

Faced with enrollment numbers that have been far below expectations, HHS has decided to no longer require those wishing to gain coverage in federally run high risk pools to prove they have been unable to find health coverage for at least six months, according to Kaiser Health News.

Starting July 1, individuals applying for coverage under the high risk pools run by the federal government in 23 states and the District of Columbia will just have to show a doctor's note that says they have a pre-existing medical condition.

Premiums will drop as much as 40 percent in 17 of the states plus the district where the federally run plans operate, bringing high-risk premiums in those states closer to the rates that can be found in the individual market. The premium costs and the requirement to prove an inability to find insurance were two obstacles that have kept the high-risk pool enrollment south of 20,000 across the nation.

There was a time when many experts believed the $5 billion set aside for high-risk pools by the health reform law wouldn't be enough to meet demand. The pools were designed to be an early carrot in the health law that would give people coverage options until 2014, when insurance carriers will no longer be able to discriminate based on pre-existing conditions.