Health Insurance: Enrollment, Benefits, Funding, and Other Characteristics of State High-Risk Health Insurance Pools

PDF Version Also Available for Download.

Description

Correspondence issued by the Government Accountability Office with an abstract that begins "A growing number of states--35 as of June 2009--have created high-risk health insurance pools (HRPs) primarily to provide coverage to individuals whose health status limits their access to coverage in the private individual health insurance market. HRPs--typically state-run nonprofit associations--often contract with a private health insurance carrier to administer the pool and offer a range of health plan options to such individuals, who are commonly referred to as medically uninsurable. Plan options vary within pools and from state to state, and like the private individual market, HRPs typically ... continued below

Creation Information

United States. Government Accountability Office. July 22, 2009.

Context

This text is part of the collection entitled: Government Accountability Office Reports and was provided by UNT Libraries Government Documents Department to Digital Library, a digital repository hosted by the UNT Libraries. More information about this text can be viewed below.

Who

People and organizations associated with either the creation of this text or its content.

Provided By

UNT Libraries Government Documents Department

Serving as both a federal and a state depository library, the UNT Libraries Government Documents Department maintains millions of items in a variety of formats. The department is a member of the FDLP Content Partnerships Program and an Affiliated Archive of the National Archives.

Contact Us

What

Descriptive information to help identify this text. Follow the links below to find similar items on the Digital Library.

Description

Correspondence issued by the Government Accountability Office with an abstract that begins "A growing number of states--35 as of June 2009--have created high-risk health insurance pools (HRPs) primarily to provide coverage to individuals whose health status limits their access to coverage in the private individual health insurance market. HRPs--typically state-run nonprofit associations--often contract with a private health insurance carrier to administer the pool and offer a range of health plan options to such individuals, who are commonly referred to as medically uninsurable. Plan options vary within pools and from state to state, and like the private individual market, HRPs typically impose waiting periods for coverage of preexisting conditions to discourage medically uninsurable individuals from foregoing health insurance until they require care. Because of the higher health care costs typically incurred by medically uninsurable individuals, all pools operate at a loss. Premiums for HRP health plans are higher than for plans offered to healthy individuals in the private health insurance market; however, these premiums are capped to limit enrollees' costs and are thus insufficient to cover the costs of enrollee health care claims. As a result, all HRPs supplement their revenues through various funding mechanisms, such as assessments on health insurance carriers and state general revenues. Federal grants are also awarded to establish and fund HRPs. As part of the Trade Adjustment and Assistance Reform Act of 2002, Congress established a program to provide grants to HRPs to offset losses and establish HRPs--commonly referred to as operational and seed grants, respectively. Subsequent legislation authorized funding for the program through 2010, including grants to be used for supplemental consumer benefits--commonly referred as bonus grants. Since 2003, the grant program has awarded nearly $286 million to state HRPs for various purposes. The Centers for Medicare & Medicaid Services (CMS), withiDepartment of Health and Human Services (HHS), administers this federal grant program. Recent health care reform proposals call for an expanded role for HRPs to enhance health insurance options for the medically uninsurable. Because of the federal funding provided to HRPs, you expressed interest in obtaining data on several aspects of each state HRP. In this report, we describe (1) HRP enrollment and enrollee demographics; (2) HRP plans' cost-sharing provisions, coverage restrictions, and premiums, and comparable information for certain private market health plans; and (3) HRPs' governance, expenditures, and funding."

Subjects

Language

Item Type

Identifier

Unique identifying numbers for this text in the Digital Library or other systems.

Collections

This text is part of the following collection of related materials.

Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

What responsibilities do I have when using this text?

When

Dates and time periods associated with this text.

Creation Date

  • July 22, 2009

Added to The UNT Digital Library

  • June 12, 2014, 7:50 p.m.

Usage Statistics

When was this text last used?

Yesterday: 0
Past 30 days: 0
Total Uses: 2

Where

Geographical information about where this text originated or about its content.

Place Name

Publication Place

Map Information

  • map marker Automatically generated Place Name coordinates.
  • map marker Automatically generated Publication Place coordinates.
  • Repositioning map may be required for optimal printing.

Mapped Locations

Interact With This Text

Here are some suggestions for what to do next.

Start Reading

PDF Version Also Available for Download.

Citations, Rights, Re-Use

United States. Government Accountability Office. Health Insurance: Enrollment, Benefits, Funding, and Other Characteristics of State High-Risk Health Insurance Pools, text, July 22, 2009; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc302766/: accessed October 18, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.