KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Michigan, New York Roll Out High-Risk Pools

States are rolling out their new high-risk pools, including Michigan and New York.

In Michigan, enrollment begins today and is open to adults 19 to 64, the Detroit Free Press reports. The pool "will provide comprehensive but not necessarily cheap coverage for people who can prove they have been denied health insurance in the past six months" and is "intended for any uninsured people in the last six months and who had been turned down by an insurer because of a pre-existing health problem. In all, persons with one or more of 62 pre-existing conditions are eligible to buy coverage, including for Parkinson's disease, kidney failure, mental retardation, paralyzing spinal cord injuries, sickle cell anemia, diabetes and epilepsy. Monthly premiums for the coverage, which would begin Oct. 1, are based on age. Young adults ages 19-24 would pay the least: $181.60 a month. People ages 60 to 64 would pay the most: $686.61 a month." The state pools are required to offer standard benefits including $20 maximum office co-pays and total out-of-pocket costs under $6,000 a year (Anstett, 8/31).

The New York Bridge Plan, New York's high-risk pool, was rolled out last week, and "charges premiums of $362 a month to upstate residents and $421 a month in the 14 downstate counties," Rochester Business Journal reports. "The unusually low rates and relatively generous benefits are possible because [state Pre-Existing Condition Insurance Plans] premiums and the plans' operational costs are federally subsidized, state insurance officials said. Once money allocated for the PCIP plan runs out, no new members would be enrolled. New York's share of federal PCIP dollars is $297 million." The plans "are slated to run until 2014, when insurance exchanges are supposed to be established" (Astor, 8/30).

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