If it looks like too many sick people are trying to sign up for the high-risk pool plan, they could be turned away, reports The Hill.
Richard Popper, deputy director of the Office of Consumer Information and Insurance Oversight at HHS, told The Hill that the bill "does give the secretary authority to limit enrollment in the plan...nationally or on a state-by-state basis." As no one is enrolled in the plan yet, he didn't see that happening "anytime soon."
HHS might also consider reallocating funding in a Robin Hood move that would shift funds from states with few applicants to those with many applicants, he said.
Healthcare experts of all persuasions have warned that the $5 billion set aside by the health reform law to fund high-risk coverage pools throughout the U.S., may not suffice to cover all the Americans with pre-existing conditions who will need coverage until 2014, when all insurance companies will be required to cover them.
Money could still be an obstacle for the uninsured. Popper noted that with premiums that will range between $140 and $900 a month, some people on limited incomes won't be able to afford to take part in the program.
HHS estimates at least 200,000 people will be covered by the program at any given time. To be eligible, applicants must be citizens or nationals of the United States, or be lawfully present; have a pre-existing medical condition; and have been uninsured for at least six months before applying for the high-risk pool plan.
The pools are going to help a significant number of people, health reform advocate Ron Pollack, founding executive director of Families USA, told The Hill, "but nobody thought they're the ultimate answer for helping people with pre-existing conditions." If it looks like the program needs an infusion of money, he said his organization might press lawmakers to allocate more to the program.
To learn more:
- read The Hill's article
- see Kyle Wingfield's blog
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