Temporary high-risk insurance pool in Senate health reform bill

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A little-noticed part of the health care reform plan proposed by Senate Democrats would create a temporary high-risk pool that would cover people turned down for health care insurance because of pre-existing medical conditions.

The pool would be a lifeline for similar pools in 35 states that cover people with chronic disorders that make them unable to buy health insurance at any price.

Under the bill sponsored by Sen. Max Baucus, D-Mont., people with pre-existing conditions would be able to enroll in a federal high-risk pool that would exist until 2013, when health insurance exchanges also proposed by Baucus would be in place. Premiums would be subsidized with $5 billion in funding.

The exchanges would be required to accept all applicants.

Details of Baucus's plan to establish a national high-risk pool haven't been hammered out.

Edmund Haislmaier, a health policy expert at the conservative Heritage Foundation, said the federal government probably would impose rules which might alter how states run their high-risk pools.

"For the 30-some states that operate pools, they would simply be subject to new rules and there would be funding to subsidize premiums," Haislmaier said.

Right now, 3,876 people are enrolled in Utah's pool, roughly a quarter of 14,360 people Ossana said are eligible. The Government Accounting Office, the nonpartisan investigative arm of Congress, says the number of eligible Utahns is closer to 53,000. The difference is rooted in different methodologies for establishing eligibility criteria, Ossana said.

Jennifer Cannaday, vice president for public policy at Regence BlueCross BlueShield, said the Baucus proposal for high-risk pools is a temporary Band-aid that won't fix the underlying problem of health care that is becoming increasingly expensive.

"It looks like from the language that there would be subsidies to help pay for premiums. But that's not fixing the underlying issue. That's just pouring more money into the same system," Cannaday said.

(Distributed by Scripps Howard News Service, www.scrippsnews.com.)

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