Early News on High Risk Pool Premiums — Steep


Well, the news on the premiums for the new high risk insurance pools (government backed coverage for people with pre-existing conditions) is going to be steep. According to Richard Popper from Health and Human Services, who is deputy director of one of the new insurance offices in the department, the coverage is going to run the gamut from a manageable $140 a month to a staggering $900.

What the heck is up with that? The rates are “keyed” to standard health insurance premiums in each state. They’re guessing the ballpark average will land between $400 and $600 a month with younger people paying less. Popper referred to the numbers as “meaningful premiums.” Uh, yeah.

Advocates are urging the uninsured to sign up anyway because they cannot be turned away. Applications will be accepted in many states starting Thursday, July 8, with the remainder coming onboard through the rest of the month. Coverage benefits will be available as early as August 1. (Consumers can find information at healthcare.gov.)

Intended as a stopgap for the uninsured with medical issues, the new plan will stay in effect until 2014 when the major provisions of health care reform take effect. To qualify to participate, an individual must have been uninsured for a minimum of six months and been turned down by a private insurer because of a medical problem. One of the biggest issues swirling around the program is whether the $5 billion allocated to cover its expense will be enough.

Popper’s estimate of enrollees at any one time was 200,000. His department, HHS, says 375,000. The Congressional Budget Office says 700,000. Like most government programs, the high risk pools will be very good for some people and very bad for others. If the premiums were being offered at any other time rather than the depths of stalled recovery from the worse recession since 1929, the plan might be greeted with more widespread approbation.

For people with pre-existing conditions who have exhausted all other insurance resources, it may be the only way to avoid medical bankruptcy (more than 60% of the bankruptcies in this country every year are due to medical debt.) The consumers best bet is to go to HealthCare.gov and learn as much as possible about the program, factoring the numbers into the potential for huge doctor and hospital bills — and to make sure you’ve exhausted all options for private insurance that might be more affordable. We can only hope that as national health care reform advances, a more equitable insurance picture will emerge for all Americans.

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