High-Risk Insurance Pools May Pour, Not Leak, Into Exchanges

High-risk insurance pools set up in many states for individuals with pre-existing and chronic conditions were originally intended to shift to the healthcare law’s insurance exchanges gradually. But a tweak in a federal funding model is incentivizing states to unload those beneficiaries quickly, which could drive exchange premiums up, according to a report by Politico.

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The high-risk pools were established to cover some 300,000 individuals nationwide whose medical conditions made it difficult to acquire affordable insurance on their own, at least until the exchanges went live and insurers were banned from denying coverage due to pre-existing conditions.

Most pools’ operators planned to transition members slowly into the exchanges to avoid adding an immediate price shock to the marketplaces. But now that HHS is offering $20 billion over three years in a reinsurance fund to help pay for high-risk customers on the exchanges, states want to dump their liability for those pools as quickly as possible, believing those emergency funds will help keep prices low for plans on the exchanges, according to the report.

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