New Questions About The High-Risk Pool


New Questions About The High-Risk Pool

Thursday, June 3rd, 2010 - 8:07
Thursday, June 3, 2010 - 07:35
A new study picked up by numerous news reports suggests that the $5 billion set aside for a high-risk pool to cover the uninsured may not be adequate.

In April, this blog raised questions about whether the $5 billion set aside in the health care reform bill for a high-risk pool would be sufficient to cover all of those who have been unable to get coverage for at least six months because of a pre-existing condition. The pool is an early test of leadership because it is designed to act as a bridge to establish expanded coverage -- one of the hallmarks of the plan -- before other reforms to lower the cost of insurance can be implemented in 2014. Targeted for implementation by June 21, the high-risk pool is one of the earliest substantive milestones for the health reform law.

A recent report released by the National Institute for Health Care Reform and picked up by numerous news outlets raises similar questions about the adequacy of the $5 billion. The report finds that between 5.6 million and 7 million Americans with pre-existing conditions could be eligible for the high-risk pool, while existing funding can only cover about 200,000 people. 

A good rundown of the report's findings by California Healthline and The Wall Street Journal Health Blog can be found here and here

If the funding indeed proves inadequate, federal officials have the authority to adjust eligibility requirements or cap enrollment. Doing so, however, could leave those who need coverage without it and undermine one of the early aspects of health reform that backers are attempting to emphasize. 

In a separate earlier post on this blog, former Senate Majority Leader Tom Daschle -- who has informally advised the Obama administration on health care reform -- described the high-risk pool as a "first milestone of import and it’s one everybody is going to be watching."

Given the stakes here, what should the administration do to stretch the high-risk pool dollars as far as possible? Please share your thoughts with us.