Thirty-four states already have high-risk health insurance pools that have produced varying results. Many high-risk pools are not open for enrollment and are expensive to operate for states and individuals. Right now, the pools at high risk throughout the United States covering 0,000 people. With the new law, an estimated two million people could join the national pool.
People enrolled in trade will pay premiums and the federal government will pay $ 5 billion in claims for new registrants. Whether $ 5 billion will be able to maintain 2 million people over the next few years 3-4 remains to be seen.
There is little explanation of how the high-risk groups will be executed in the bill on health care in the Senate. According to Kaiser Health News Secretary Kathleen Sebelius has the power to decide whether high-risk pools will be run by HHS, States or by a non-profit.
The HPA is also responsible for the creation and execution of the program with a few guidelines. Here are some eligibility criteria and other guidelines:
- Applicants must be denied health insurance coverage because of a preexisting condition;
- Candidates can not be covered by another form of insurance and have not had coverage for at least six months;
- The older candidates can not be charged more than four times more young people registered are charged;
- Health insurance plans must cover 65 percent of health costs and meet the annual out-of-pocket limits defined in the bill, and;
- Enrollees will pay premiums will be based on the "standard rate", which will cost the average premium charged by private insurance companies for coverage that is similar.
It will be interesting to see how the HHS handles this task because it could open the way for the implementation of health reform.
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