19 States Refuse to Create High-Risk Pools Despite $5B in Federal Funding

Arizona has become the 19th state to reject a federal invitation to set up a high-risk pool to cover patients with pre-existing medical conditions under health reform, according to a report by the Arizona Republic.

When a state refuses to set up a risk pool, the healthcare reform law directs the federal government to set one up for them. The risk pools are necessary until Jan. 1, 2014, when insurers will be barred from not covering adults with preexisting conditions. The law’s prohibition against not covering children with pre-existing conditions starts on Sept. 23, 2010.

Starting July 1, the federal government is offering states $5 billion over three years to operate a high-risk pool themselves or provide funding for the federal government to do so. Each state’s allocation is based on population and need, with California, for example, getting the largest allocation, at $761 million.

Arizona would have received $129 million to operate a risk pool, but Gov. Jan. Brewer said the money might not be enough to pay for the high-risk pool. “In light of Arizona’s existing fiscal challenges, I cannot commit the state to a program without confidence that there is funding available to sus- tain it,” the Republican governor wrote in a letter to Department of Health and Human Services Secretary Kathleen Sebelius.

The states’ choice on high-risk pools is their first major decision in the implementation of healthcare reform, the Patient Protection and Afford- able Care Act, since it passed in March.

The other states refusing to set up risk pools are Alabama, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia and Wyoming.

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