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Tuesday, April 27, 2010

Health Care Faces First Big Test with States

The first real test of how cooperative the states will be in implementing the massive new health care reform law comes on Friday, and early indications are that it’s going to be at best a bumpy road.

On Friday, states must decide whether to help the Department of Health and Human Services set up or expand high-risk insurance pools by the June 21 deadline set in the law, or, in the alternative, leave HHS to do it all by itself.

The pools, modeled after similar programs that already exist in more than 30 states, are designed to quickly provide coverage to adults with pre-existing medical conditions. People will qualify to join the pools, which will offer catastrophic coverage but still have high premium costs, if they’ve been without insurance coverage for six months.

HHS has $5 billion to finance the pools, which will be phased out in 2014 when insurance companies will be banned from denying coverage to people because of pre-existing medical problems.

The level of cooperation could set the tone for implementing the rest of the massive overhaul plan, much of which will be put in place by the states.

Georgia Insurance Commissioner John W. Oxendine, a Republican candidate for governor, said his state won’t implement the high-risk pool program because it will “ultimately become the financial responsibility of Georgians in the form of an unfunded mandate,” he wrote in a letter to HHS Secretary Kathleen Sebelius.

Many states are concerned that the $5 billion HHS has to implement the program will quickly run dry, leaving cash-strapped states with another tab.

In Kansas, insurance officials have questions about costs and eligibility, among other factors.

“The concern that they had, and I think it’s similar to all the other states, is there were a whole lot of questions and not a lot of answers,” said Linda Shepphard, director of the accident and health division at the Kansas Insurance Department. - Politico Story

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