High-risk pools may not help everyone

Health-care headlines

TEXT OF STORY

Kai Ryssdal: The House approved the financial reform bill last night. The Senate is going to wait until after the long holiday weekend to take its vote. But one key part of the other big reform bill that came out of Washington this year went into effect today: Temporary, high-risk insurance pools for people who can't get insured because of preexisting conditions. Some of those pools started taking applications today. But it's not yet clear how many people they'll be able to help.

Marketplace's Nancy Marshall Genzer explains.


Nancy Marshall Genzer: The health care reform law will make it illegal for insurers to refuse people because of preexisting conditions. But that doesn't take effect until 2014. In the meantime, people who've been denied coverage can apply for insurance through the temporary pools. But the pools are really just a drop in the bucket. The new law budgets $5 billion for them.

Austin Frakt is a health economist at Boston University. He says the government might have to limit enrollment, so the money doesn't run out.

Austin Frakt: So if you start denying people, that doesn't look good. On the other hand, we're in a climate of fiscal belt tightening.

So it would be hard to persuade Congress to pony up more money. There are upwards of 40 million uninsured Americans. But the Congressional Budget Office says enrollment will have to be limited to about 200,000 people. Otherwise, the pools will be drained before 2014.

Richard Popper is a deputy director at the Department of Health and Human Services. He says the department can make do by shifting money away from states with low enrollment.

Richard Popper: We'll be monitoring the actual expenditures closely, to reallocate between states -- if enrollment is lackluster in one state, and in another state, it's more robust.

The states might not like that too much. Linda Sheppard works for the Kansas insurance commissioner.

Linda Sheppard: We would want to be able to have those funds that have been allocated to us available for those people, here in Kansas.

The bottom line for the uninsured? Apply for the pools early, before the money runs out.

In Washington, I'm Nancy Marshall Genzer for Marketplace.

About the author

Nancy Marshall-Genzer is a senior reporter for Marketplace based in Washington, D.C. covering daily news.

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