Federal insurance pool open to high-risk Texans
Many uninsured Texans with medical conditions will be able to sign up for health insurance beginning today under a new federal program.
The so-called high-risk pools are intended to provide insurance to the previously uninsurable. The pools, which will cost $5 billion nationally, were introduced as part of the sweeping health care law passed by Congress in March.
Coverage will begin Aug. 1 if people apply by July 15, officials said.
“People with pre-existing conditions will be treated like everyone else,” said Jay Angoff, the director of the federal Office of Consumer Information and Insurance Oversight, which is overseeing the program.
States had the option of running the programs or al-
lowing the U.S. Department of Health and Human Services to run them.
Texas — along with 21 other states — opted out, and the federal government will administer the program, now known as the Pre-Existing Conditions Insurance Plan. The potential allocation for Texas, if it had chosen to run the pool, was $493 million, according to Health and Human Services.
Gov. Rick Perry, who has opposed the federal insurance reform law, said in a statement Wednesday that Texas officials “hope that the federal high risk pools are run effectively and efficiently.”
“We are still concerned about the lack of reliable federal funding and what it means for Texans once the federal funding has run out. The State of Texas has been addressing the needs of these high risk individuals with our own pool for 12 years, and will continue to do so.”
Texas’ high-risk pool costs consumers twice as much as the federal one. People enrolled in the federal pool will pay a premium equal to stan- dard market rates.
Enrollees in the state plan cannot simply switch to the federal plan because to be eligible, a person must have been without insurance for the pre- vious six months.
Health and Human Services has access to some information to verify eligibility, but Richard Popper, director of the federal insurance programs, said the department would rely largely on the honesty of the applicants.
Deeia Beck, head of Texas’ Office of Public Insurance Counsel, which aims to assist consumers, said the federal government should have allowed people to drop the state coverage and get into the federal plan.
“It’s unfortunate that the feds didn’t address that properly,” Beck said.
The federal pool is intended to be a stopgap. Starting in 2014, insurers will be prohibited from discriminating against applicants based on pre-existing conditions, and people will have access to private health insurance choices through exchanges, which will be marketplaces for health plans.