HHS Launches High-Risk Pools, Consumer Website As Part Of Health Reform Implementation

U.S. health officials on Thursday launched the Pre-Existing Condition Insurance Plan, a provision of the new health reform law (PL 111-148) that aims to temporarily provide coverage to individuals with health problems through high-risk insurance pools, the AP/Chicago Tribune reports (Alonso-Zaldivar, AP/Chicago Tribune, 6/30).

Twenty-nine states and the District of Columbia have elected to administer their own pools, while 21 states have opted to let the federal government run the pools. According to the Wall Street Journal, coverage under federally run pools is expected to commence on Aug. 1 for consumers who apply by July 15. However, several states -- including California, Maryland and Michigan -- anticipate that coverage will not be available until September.

Under the program, eligible U.S. residents will receive coverage for care from primary care physicians, specialists and hospitals (Adamy, Wall Street Journal, 7/1). The pools are modeled after the federal Children's Health Insurance Program, which gives states flexibility to alter benefits and premiums to reflect the needs of their marketplace, according to Richard Popper, deputy director of HHS' Office of Insurance Information and Oversight (Reichard, CQ HealthBeat, 7/1).

To qualify, individuals must have been uninsured for at least six months and denied insurance coverage because of a pre-existing condition, possibly requiring a letter from a physician.

Monthly premiums will range from $140 to $900, based on a person's age and state of residence. For example, a 50-year-old California resident could expect to pay $575 monthly for a comprehensive policy with a $1,500 annual deductible and $2,500 annual cap on out-of-pocket expenses. However, the program will not charge enrollees more because of their medical condition (Wall Street Journal, 7/1).

HHS officials have said 200,000 U.S. residents will be covered through the pools at one time, but have predicted the program could cover as many as 350,000 U.S. residents because of patient turnover (CQ HealthBeat, 7/1).

The government has allotted $5 billion to fund the pools until 2014, when insurers will be barred from denying coverage based on pre-existing health conditions, and low- and middle-income U.S. residents will become eligible for insurance subsidies (AP/Chicago Tribune, 6/30).

Obama Administration Unveils New Health Care Website

On Wednesday, the Obama administration unveiled its new HealthCare website, the Washington Post reports. On the site, U.S. residents can apply for the high-risk pools.

The site also provides information on a range of public and private health insurance plans. For example, the site offers insurance plan information based on an individual's income, job status and ZIP code, and it allows users to see how their coverage options might change as provisions of the new reform law take effect. According to the Post, federal health officials expect the site to list prices and offer plan comparison charts by October (Aizenman, Washington Post, 7/1).


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