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High-Risk Pool for Uninsured Could Exceed Budget, Analysis Says

May 27, 2010

A forthcoming temporary high-risk pool for the uninsured with pre-existing health conditions could quickly go over budget, according to a new analysis.

The $5 billion program, expected to launch as soon as July, is part of the new health reform law. Its purpose is to extend temporary coverage to the uninsured until 2014, when health plan reforms, subsidies and insurance exchanges become operational.

Between 5.6 million and 7 million people could qualify for coverage through these high-risk pools, according to the National Institute for Health Care Reform, a not-for-profit health research group created by the United Auto Workers, Chrysler Group, Ford Motor Co. and General Motors Co. The institute is affiliated with the Center for Studying Health System Change.

But the $5 billion allocated to the program through 2013 would cover as few as 200,000 people annually, according to the report.

Twenty-nine states and the District of Columbia have agreed to run the programs, while 19 states declined, meaning the U.S. Department of Health and Human Services will administer high-risk pools in those states. Two states are undecided.

“How much leeway they have to modify the outlines of the program is uncertain,” the report concludes.

Filed by Rebecca Vesely of Modern Healthcare, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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