It’s a good time to take a look at the high-risk pools.
There are two basic kinds of high-risk pools – about 35 states have some form of high-risk pools that predate the Affordable Care Act, and all states have Pre-Existing Condition Insurance Pools created by the federal law.
Let’s look at the “PCIPs” first. (Here’s a federal website that explains them.)
Some states administer these “PCIPs” themselves, and some let the federal government run them. “Red” states tended to hand it to the feds, “blue” states tended to run it themselves but there were enough exceptions in both directions to make this less political than the fight over the state-run health insurance exchanges going online in 2014. Here’s a map.
These pools were supposed to be temporary — a bridge to get some uninsured people to 2014. They never were going to cover everyone and they never were going to be cheap for these individuals, despite the $5 billion in federal subsidies. Enrollment in states was slow and uneven, but after tweaks by the Department of Health and Human Services to the premium structure and more outreach, it picked up a bit. The pools were meant to provide a degree of help to people with serious and expensive medical conditions who hadn’t been able to get insurance for at least six months. It was not meant to be a permanent or comprehensive solution. According to HHS, about 100,000 people are covered.
But some of those people were very expensive to cover. By early this year, federal officials suspended enrollment. (In February for the federally administered ones, in early March for the states.) They wanted to make sure that the $5 billion didn’t run out. People who are in the pools will continue to be covered but new people can’t come in. In January, the PCIP pools will close and the people in them can be covered in the regular state exchanges like everyone else. Continue reading