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Not Enough Money for High-Risk Pools, CBO Says

Elyas Bakhtiari, for HealthLeaders Media, June 25, 2010

Rather than call for caps on the pools, Enzi asked HHS to provide better funding for the program in a letter to HHS Secretary Kathleen Sebelius. “Given the importance of the high risk pool program and the reliance on this program of millions of Americans with pre-existing conditions and life-threatening diseases, it is crucial that this program be fixed and fully funded,” he said.

In the same letter, Republicans criticized the government for not establishing the pools by the initial deadline of 90 days after the legislation was signed on March 23.

Enzi also claimed that at least 19 states have declined to participate in the program. However, in states that decline to administer high-risk pools with federal funding themselves, individuals will be eligible for a high-risk pool that will be run by the federal government.

At least one state that plans on participating in the program, Illinois, won't make the July deadline because lawmakers failed to pass the necessary legislation to set up the pool in time. The state plans on enrolling people by mid-August, according to the Chicago Sun-Times.

Elmendorf cautioned that these were only preliminary estimates, and said many of the details are still up in the air. "The law provides little guidance about how the requirement for participants to have a preexisting condition will be met, how applicants’ lack of insurance coverage will be monitored, and how the program will interact with existing high-risk pools."


Elyas Bakhtiari is a freelance editor for HealthLeaders Media.

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