Kentucky, Washington Offer Coverage for Chronically Ill
Beginning Jan. 1, Kentuckians with "high-cost medical conditions" will be offered more insurance choices through a new state program, the Lexington Herald-Leader reports. Approved by the 2000 state General Assembly, the program called, Kentucky Access, is a "state-subsidized insurance pool" for people with chronic medical conditions, such as cancer. The $33 million plan, funded in part by the state's share of the national tobacco settlement, will allow insurers to "decline" to cover customers with potentially high bills and will instead divert people with high-cost conditions from the individual insurance market into a high-risk pool. Those high-risk individuals could purchase one of three plans through the state. State Insurance Commissioner George Nichols said that "separating people with chronic illnesses from the rest of the insurance market translates to more choices of insurance carriers, lower rates and a steadier individual market for all Kentuckians." Twenty-seven states have similar pools, but Kentucky is the first to use its tobacco settlement to fund such a program. About 131,800 Kentucky residents buy their own insurance. Kentucky Access officials will target 2,000 of these customers and expect to enroll 1,200 in the program's first year (Richardson, Lexington Herald-Leader, 12/7).
A Precarious Health History
The Assembly has been "tinkering with health insurance" since 1994, when it attempted to "forc[e]" Kentucky's insurance companies to cover everyone in the state, while simultaneously capping rates. As a result, all but two companies -- Anthem Blue Cross and Blue Shield and Humana Inc. -- fled the state, leaving Kentucky's insurance market in "disarray" (Chellgren, Cincinnati Enquirer, 12/7). Since the plan's passage, however, two insurance companies have returned to the state and a third is expected to announce its return in the coming week. Moreover, by removing high-cost customers from the individual insurance market, Kentucky officials expect premiums to drop between 5% and 10% over the next year (Lexington Herald-Leader, 12/7). But given the state's history with health insurance reform, many remain skeptical about the program. Jim Powell, a representative of the Kentucky Disabilities Coalition said the risk pool is "designed only" to protect insurers' profits and will mean little for consumers. "It sounds better. It doesn't feel better," he added (Cincinnati Enquirer, 12/7).
Washington Reopens Individual Policies
Washington state insurers have reopened enrollment in individual health policies, prompting thousands of inquiries from individuals, the Spokane Spokesman-Review reports. On Dec. 1, Premera Blue Cross and Group Health Cooperative of Puget Sound opened enrollments, while Regence BlueShield followed suit on Dec 4. Last year, the state's three largest insurers withdrew their individual plans from most counties, citing substantial losses on private coverage. As a response, the state Legislature last spring passed a bill to extend the waiting period for people with "pre-existing medical conditions" and create a separate pool for customers with "high-risk" conditions. Although the premiums for those in the high-risk pool are 150% of those for other plans, state insurance commissioner spokesperson Barbara Stenson said that due to the "rich" coverage, many people will find the plans a "good buy." However, the state's high-risk pool is intended to capture only 8% of all individual insurance buyers, and thus maintains a rigorous screening process. The new policies will take effect Jan. 1. An "extensive" explanation of the state's individual market is posted on the Washington insurance commissioner's Web site, www.insurance.wa.gov (Caldwell, Spokane Spokesman-Review, 12/5).