Sinking or Swimming in the High-Risk Pool?

On the front page of the New York Times this morning, I saw an article that highlights a problem with proposals to model a new component of national healthcare coverage on states’ high-risk pools. Earlier this year, I had been looking at the Connecticut High-Risk Pool (created by the Connecticut Health Care Act of 1975).

What it is? Connecticut High Risk Pool is managed by the Health Reinsurance Association (composed of all private insurance companies and HMOs that offer health insurance in CT) and offers a comprehensive healthcare plan to eligible Connecticut residents who cannot get other coverage because of pre-existing conditions. State law caps HRA rates at 125% -150% of standard insurance rates.

Who it “serves”? Connecticut residents between 19 & 65 and their dependents can be eligible for the high-risk pool. The Health Reinsurance Association offers several plans, but the range of cost is largely covered by two closely related examples:
· The special Low-Income Portability TAA Plan costs a 45 year-old male $317.63 per month; a 45 year-old female would pay $395.40 a month.
· The same plan for a non-low-income individual costs $972.53 per month for a 45 year-old male and $1210.65 for a 45 year-old female.

In my opinion, the high-risk pool is dangerous because it appears to offer safety-net coverage, while actually being priced out of reach of the very people who most need it. While the new Charter Oak Health Insurance program may help cover many Connecticut residents who would earlier have had no option but the high-risk pool or no coverage, the program’s co-pays and deductibles may still bar our state’s sickest residents from participating.
Connie Razza