Sebelius' comments on potential role of state high risk pools in health reform: NASCHIP pleased

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today issued a letter to governors and independent insurance commissioners asking each state to express their interest in participating in the temporary high-risk pool program established by the new health insurance reform law. States were provided a number of options for participation including building upon existing state high-risk pools. Secretary Sebelius specifically notes that "In reviewing the existing state high risk pools, there is much common ground in the benefits currently provided."

Leaders of existing state high risk pools are letting it be known they are ready and prepared to assist the Secretary in her goal of building on existing state programs in this important initiative to provide expanded access to health coverage for persons with pre-existing conditions who cannot otherwise obtain health insurance.  

"We were pleased to hear Secretary Sebelius's comments on the potential role that state high risk pools can play in this first critical leg of health reform," says Vernita Bridges-McMurtrey, Board Chair of the National Association of State Comprehensive Insurance Plans (NASCHIP), which represents risk pools nationwide.  "There is no question in our minds that we can accomplish this first leg of health reform better, faster, and less expensively for the national risk pool. The country's 34 state high risk pools are uniquely positioned to serve as an immediate mechanism to efficiently administer this interim expansion of health care for Americans who have been uninsured for six months and who have pre-existing conditions.  Many of these pools have been serving Americans with pre-existing conditions for more than 20 years."

NASCHIP and its member state high risk pools have been gearing up in recent months for what they hope will be a central role in health reform.  "The existing high risk pools have already invested the time and funding into developing the infrastructure necessary to serve high risk individuals.  Implementing the national risk pool would simply mean adapting our infrastructure to the requirements laid out in the health reform legislation," said Ms. Bridges-McMurtrey.

"NASCHIP state high risk pool executive directors also look forward to providing technical assistance to HHS for fast track implementation of the new federal high risk pool in states that lack an existing high risk pool.  NASCHIP and its member pools have a long history of collaboration with one another and with the federal government in assisting new risk pools through implementation and in administering federal risk pool funding," said Ms. Bridges-McMurtrey.  Since 2003, state risk pools have received federal funding under a grant program established under the Trade Adjustment Assistance Act.  Up to $ 75 million per year has flowed into eligible state high risk pools to assist in offering premium subsidy programs, funding disease management programs and improved benefits for risk pool enrollees.  Some of the funding has also helped defray pool operating losses.

"Federal funding has meant a great deal to state risk pool members nationwide over the years, especially lower income individuals who otherwise might not be able to access coverage, " noted Ms. Bridges-McMurtrey.