In first test implementing health reform, state reconsidering high risk pool plans

In our state’s first test implementing federal health reform, Governor Rell has asked DSS and other agencies to start over in their decision to build onto CT’s high risk pool. The federal Accountable Care Act provides funding for temporary programs to provide coverage to people left out of the private market due to; the programs end in 2014 when private insurers are barred from excluding people based on pre-existing conditions. States have the option to build their own program or use a common program created by the federal government; about half of states have chosen each option. The pool was supposed to be up and running yesterday; other state pools are taking applications now. CT’s share of the federal money is $50 million. In April Governor Rell notified the feds that CT would be building on our existing state high risk pool. CT’s current high risk pool, created in 1976, serves only 2,529 state residents, mainly due to very high premiums. The administration’s decision has been criticized by advocates and policymakers for very high premiums and deductibles, high administrative overhead and no clear point of contact for consumers. The plan’s administrators included five groups/agencies -- DSS, EDS, CID, HRA and United Healthcare -- and would have included three different call centers. Advocates were concerned that high administrative costs would divert resources away from medical care to people with serious health problems. The Governor has asked the agencies to reconsider using the federal program option for CT residents with serious medical issues.
Ellen Andrews