On May 27, the National Institute for Health Care Reform (NIHCR) released a study projecting the cost and extent of coverage offered by the high-risk insurance pools established under the national health care reform law.  The study estimates that the $5 billion the federal government has committed to subsidize the pools may only be enough to offer coverage to 200,000 individuals, unless states take actions to maximize the value of those dollars.  Twenty-nine states and the District of Columbia have opted to run their own high-risk pools, 19 have opted to let the U.S. Department of Health and Human Services (HHS) run the pools for them, and two have yet to decide. 

From the report:

The Patient Protection and Affordable Care Act (PPACA) of 2010 includes insur­ance market reforms and income-based subsidies designed to make health cover­age more accessible and affordable. Most of these measures do not take effect until January 2014. Until then, people with pre-existing medical conditions who lack access to employer-sponsored or public coverage may continue to have trouble finding affordable coverage in the private nongroup, or individual, market (see box on page 2 for more about underwriting practices in the nongroup market and state regulatory responses).

To bridge the gap, the new law provides for an interim national high-risk pool, modeled on those already operating in 35 states (see box on page 3 for more about state high-risk pools). Possibly starting in some states as early as July 1, 2010, the program will provide subsidized coverage to uninsured people with pre-existing medical conditions. This analysis summarizes provisions of the new temporary high-risk pool program, estimates the population that might be eligible and reviews some of the key policy issues that must be resolved as the program is implemented. 

Full report: Health Coverage for the High-Risk Uninsured: Policy Options for Design of the Temporary High-Risk Pool (PDF | 329.1 KB)

National Institute for Health Care Reform. (2010). Health coverage for the high-risk uninsured: policy options for design of the temporary high-risk pool. Merlis, M.