HHS Secretary Seeks to Establish High Risk Pools

April 5, 2010

Looks to states to see how they would like to proceed

The new healthcare reform bill requires states to establish a high-risk pool to assist individuals with pre-existing conditions purchase insurance coverage within 90 days of its enactment (March 23, 2010). Friday Secretary Sebelius sent letters to governors and insurance commissioners with some of the rules governing the program and asked that they report back how they would like to proceed. A large degree of discretion is being left to the states on how to set up and manage these programs. If the states cannot or will not comply, HHS will administer one for them. HHS Secretary Sebelius said that to build a network of providers within 90 days is impossible so she would look to existing state programs and not-for-profit insurance carriers (as a last resort) as an interim solution until 2014 when all insurance companies would have to take all comers.

Meanwhile, in a Wall Street Journal editorial, it criticized Massachusetts Governor Duval Patrick of playing politics with the introduction of insurance price controls. Health costs in the state have risen to the highest in the country. Meanwhile 235 of 274 insurer requests for premium increases have been rejected. Also making news in Massachusetts is the thousands of healthcare consumers "gaming" the system. They are purchasing coverage when they need to cover pricey medical care and drop it when they no longer "need" it. Insurance executives claim this is driving up the costs for others and small businesses.

Rounding out the news is the report that Angela Braly, CEO of Wellpoint received a 51% pay increase.

Other articles of interest in today's April 5, 2010 NAHU Newswire include:

• New Healthcare Law Made No Changes to COBRA Coverage
• Health Reform Law Will Expand Coverage for Millions aged 19-29
• New Limits for FSA's Discussed

<<- Return to News