ALEXANDRIA, VA – This week has been designated as “Cover the Uninsured Week,” an effort to get elected officials, the media and the public to focus on issues facing America’s uninsured. Therefore, the Council for Affordable Health Insurance (CAHI) will offer a solution a day from one of its experts, who will discuss a topic which directly affects the uninsured.

Today’s issue: Fund High-Risk Pools by CAHI Director of Federal Affairs Angela Hunter.

Comprehensive Health Insurance Plans (CHIPs), commonly known as state high-risk pools, are special state health insurance programs established by state legislatures.

Risk pools, most of which are based on the National Association of Insurance Commissioners Model Health Plan for Uninsurable Individuals Act, are non-profit entities overseen by appointed, diverse boards. They have been in existence for more than 25 years and provide coverage for the 1 to 2 percent of the population  usually the self-employed and employees of small businesses that don’t offer health insurance  who are uninsured and have a high-risk health condition such as cancer, diabetes or heart disease and have been turned down when applying for insurance.

More than 172,000 people with medical claims in excess of $1 billion were covered under 29 operational risk pools in 2003. Enrollees pay a premium – capped to ensure price protection  for their insurance. Premium revenue generally covers 50 to 60 percent of the program’s cost. The rest  $450 million in 2003  must be made up through other revenues, usually through assessments on insurance companies doing business in the state.

However, growing pressure from enrollment is increasing the need for other sources of revenue. Federal funding would help relieve that pressure and allow more uninsurable people to get coverage.

Senators Judd Gregg(R-NH) and Max Baucus (D-MT) have introduced S. 2283, and Rep. Ed Towns (D-NY) has introduced H.R. 1110. Both bills extend and increase the federal high-risk pool operational grant funding to $75 million each year for five years (2005-2009). S.2283 would extend $15 million in seed grant funding through FY 2005. High-risk pools aren’t risky, they play a critical role in a market-oriented health care system by providing a safety net for those who need coverage but are unable to get it because of a pre-existing condition.

To schedule an interview with CAHI Director of Federal Affairs Angela Hunter, please contact Tom Gardner, director of communications, at (703) 836-6200 x386 or tgardner@cahi.org.

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