NCPA - National Center for Policy Analysis

High-Risk Insurance Pools Short on Enrollees

February 17, 2012

In order to stem the gap from the passage of the Affordable Care Act (ACA) to its implementation in 2014, the legislation allowed for the creation of federally funded high-risk insurance pools throughout the states.  These pools would provide immediate health care access to patients without insurance and suffering preexisting conditions.  However, despite expectations from the Obama administration that the pools would be substantially oversubscribed, they have experienced participation far below expectations, says Politico.

  • The pools were allotted $5 billion to provide coverage for all participants -- an allowance that many thought would quickly be depleted with so many subscribers.
  • While participation has varied from state to state, the programs on the whole are providing care for very few people.
  • Just about 45,000 people have signed up in total -- well short of the 375,000 the Medicare actuary had predicted for the end of 2010.

The dearth of subscribers has caused some to question the much-publicized blight of the uninsured and those suffering from preexisting conditions.  However, though the lack of involvement caught many analysts by surprise, a number of explanatory factors have been proposed.

  • The costs to sign up for the high-risk pools are high -- after all, insurers know that the majority of those signing up will require costly care for serious ailments.
  • Additionally, the new pools are competing with "legacy pools" (pools that the individual states had already created for the same purpose long before the ACA), which have attracted some 222,000 enrollees.
  • As of last summer, government figures showed that seven out of 10 people who entered these new high-risk pools were enrolling in legacy pools as opposed to the federal systems.

Source: Jason Millman, "High-Risk Insurance Pools Short on Enrollees," Politico, February 13, 2012.

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