CMS awards 30 states to fund expanding high-risk pools

WASHINGTON – Thirty states will share more than $49 million in grants awarded by the Department of Health and Human Services to support their high-risk pools.

More than 200,000 individuals whose health status prevents them from securing traditional health insurance coverage are enrolled in these pools, and the numbers are growing.

New Hamphire has 1,000 high-risk pool enrollees, but its enrollment is rising steadily, said David Sky, director and actuary of the Life Accident & Health Division of the New Hampshire Insurance Dept. The state will receive $325,000 in bonus grants and $557,000 for operational costs.

While HHS didn’t specify which of the five bonus grants that the state had applied for were being funded, the state will make that decision, he said. The biggest, most costly initiative is the low-income premium subsidy or deductible waiver, said Sky.

CoverColorado will receive $1.8 million. Operational costs are running approximately 8 percent of total cost, which has remained stable for several years and is far less than in the for-profit insurance industry, said Executive Director Suzanne Bragg-Gamble.

Approximately $606,000 is earmarked for care-management initiatives. While Bragg-Gamble hopes to use some grant money to enhance CoverColorado’s Web site, no decision has been made yet on what will be funded.

Kentucky Access’ enrollment increased by 306 from last year to 4,431 this year, with medical and pharmacy costs driving the increases in operational costs, said Ronda Sloan, public information officer for the Kentucky Dept. of Insurance. The state will receive $938,275 for operational costs and $750,000 for disease management.

The Mississippi Comprehensive Health Insurance Risk Pool Association, which has more than 3,500 enrollees, will receive $1.41 million for operational costs and $525,000 in bonus grants. Executive director Lanny Craft said the bonus grant will be used for a disease management pilot focusing on diabetes and coronary artery disease.

The Oregon Medical Insurance Pool (OMIP) currently insures about 16,100, with the highest at about 18,600 individuals in April 2008, said Manager Tom Jovick.

Of the $2.68 million it has received, $950,000 will be used for a remote telemonitoring disease management program for complex high-risk patients, copayment elimination for evidence-based medication and reduction of generic prescription copayment to $5.

Jovick said that the OMIP board of directors will decide at its September meeting “how to best use the funds to the benefit of the enrollees.”