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Tip Sheets

Covering high-risk insurance pools: Mike Shields

The federal government and states are scrambling now to create temporary high-risk pools for the medically uninsurable by July 1. As one of the first provisions of the Patient Protection and Affordable Care Act to go into effect, it will serve as a test case for implementation of the new law and it should be closely followed.

Some states with existing high risk pools are passing laws to ensure their programs comply with the new federal rules and are eligible for some of the $5 billion in federal funding. Other states are refusing to alter their programs and ceding responsibility to the federal government. But apart from being a policy story, it’s of great interest to all your readers, viewers or listeners who have pre-existing conditions and are struggling to find coverage.

AHCJ has asked some reporters covering the topic for story tips, suggestions and resources. We expect to add more tips and resources to this package as the story develops. If you have something to contribute, please send it to

By Mike Shields
Kansas Health Institute News Service

Covering high-risk pools

Tips from Victoria Colliver, San Francisco Chronicle

Tips from Sarah Varney, KQED Public Radio and The California Report

Tips from Dave Hage, Minneapolis Star Tribune

Tips from Mike Shields, Kansas Health Institute News Service

In an earlier feature on covering health reform, four journalists on the front lines offered their advice and suggestions on what needs to be covered next and how to approach this complex topic.

Recent coverage

Reform could mean end to state health care pool, Chen May Yee, Star Tribune  

$5 Billion In Federal Funding For High-Risk Pools May Not Be Enough, Christopher Weaver, Kaiser Heatlh News 

Health Reform Gets a High-Risk First Test, Evan George, Los Angeles Daily Journal (PDF posted with the permission of Daily Journal Corp. 2010)

New Health Law Expands High-Risk Coverage, Sarah Varney, KQED/The California Report

Health reform may alter high-risk pools, Victoria Colliver, San Francisco Chronicle

Governor vows to implement health care reforms, Victoria Colliver, San Francisco Chronicle

California gung ho on health care law, Carolyn Lochhead, San Francisco Chronicle

States begin considering high-risk pool provisions of health reform, Mike Shields, KHI News Service 

High-risk patients may be stuck paying high rates , Carla Johnson, AP medical writer

States Must Decide On Joining High-Risk Pools, Julie Rovner, NPR

McCain's Health Plan Focuses On High-Risk Pools, Julie Rovner, NPR

States Must Decide On Joining High-Risk Pools, Julie Rovner, NPR

The First Test Of New Health Law: Covering Hard-To-Insure People, Mary Agnes Carey, Kaiser Health News

Health-care law will alter high-risk pool, but just how hasn't been worked out, Carol Ostrom, The Seattle Times

State OK's fed health plan for those in high-risk pool, Carol Ostrom, The Seattle Times


Department of Health and Human Services: Next Steps in High-Risk Pool Program

Kaiser Family Foundation
State High Risk Pool Programs and Enrollment, December 2008
Fact sheet on the temporary federal high-risk pool

National Conference of State Legislatures

National Association of Health Underwriters

National Association of State Comprehensive Health Insurance Plans

National Association of Insurance Commissioners

Mike Shields
Mike Shields


If you're in a state with an existing high-risk pool, like Kansas, the new federal pool will be more generous and affordable, though probably still too costly to help a lot of people.

Persons anywhere already enrolled in a more expensive state pool essentially will be stuck there because the new risk pools will only be available to people who have gone six months without coverage.

Kansas officials say they most likely will operate two, parallel pools: The federal pool and the existing state pool.

Seems like a lot of extra red tape for a program that is meant to be stop-gap until 2014. But so far there doesn't seem to be a solution for that apart from some relatively quick syncing with federal law by state legislatures, which is unlikely in Kansas and maybe elsewhere.