Tags: health | insurance | high | risk

Insurance Pools for 'High-Risk' Patients Running out of Money

Saturday, 16 Feb 2013 08:06 AM

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A large number of Americans who have been refused health insurance because of preexisting medical conditions received bad news Friday from the Obama administration.

Tens of thousands will be blocked from a program designed to help them because money is running out, the Washington Post reports.

Obama administration officials said new applicants will be shut out of the state-based “high-risk pools” set up under the 2010 health-care law as soon this weekend and no later than March 2, depending on the state.

This will not affect the coverage afforded to approximately 100,000 people who are now enrolled in the high-risk pools.

“We’re being very careful stewards of the money that has been appropriated to us and we wanted to balance our desire to maximize the number of people who can gain from this program while making sure people who are in the program have coverage,” said Gary Cohen, director of the Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight.

From its start in summer 2010, the program was thought of as a temporary bridge for those who are uninsured. The plan, however, was for the pools to last until 2014, when Obamacare will prevent insurers from rejecting people who are already sick, enabling them to buy plans through the private market.

Analysts have consistently doubted whether the $5 billion allocated by Congress for the Pre-Existing Condition Insurance Plan — as the program is called — would be sufficient.

While only about 135,000 people have gotten coverage, their insurance is proving to be more costly than predicted.

Because of their lack of insurance, many people go untreated, which worsens their medical problems. When they finally do get coverage through a high-risk pool, the care they require costs more than initially expected.

This situation has taught Cohen a hard lesson.

“What we’ve learned through the course of this program is that this is really not a sensible way for the health-care system to be run,” he told The Post.

Of the original $5 billion provided by Congress, less than half remains available for the remainder of 2013 — enough only to provide coverage for those already in the pools, according to administration estimates.

When asked why the Obama administration has not requested additional funds from Congress to keep the program active, Cohen said: “My responsibility is to work with the appropriation we have.”

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