May 1, 2010-Bismarck Tribune
Feds to run high-risk pool for North Dakota
By REBECCA BEITSCH Bismarck Tribune | Posted: Saturday, May 1, 2010 2:00 am
North Dakota is leaving control of a new program required by the health care law in the hands of the federal government.
The law paves the way for a new high risk pool — a government-run plan that offers health insurance for those too sick to get it on their own — to be run either by the states or, if they decline, by the federal government.
Friday was the last day for states to inform the federal Department of Health and Human Services what action they’d be taking, and a letter penned by Insurance Commissioner Adam Hamm said the state will leave responsibility for the high risk pool with the federal government. At least 11 other states took the same action.
“I had serious concerns that the money the feds have allocated would be sufficient to run it until it expires,” Hamm said.
As outlined in the law, $5 billion would be doled out to states to run the temporary program until it expires on the last day of 2013. North Dakota’s share of that money would be about $8 million.
However, Hamm said research from another federal entity, the Centers for Medicare and Medicaid Services, showed that money could run out by 2011 or 2012.
“North Dakota can’t afford to be stuck with an unfunded mandate,” Hamm said.
Regardless of the financial aspect, because of the biennial sessions, the state also would have faced difficulty in creating a high risk pool on a timeline that corresponded with the federal governments.
“It’s just the timing,” said Rep. George Keiser, R-Bismarck, chairman of the committee that held a meeting on the new health care law Wednesday. “We can’t give him (Hamm) any more money to operate the high risk pool. We can’t give him any more staff. He can’t get it up and running. Because it is temporary, we’ll let them have it and sit back and watch them struggle in operating it.”
Although the state already runs its own high risk pool, CHANDS, that program cannot be used as a substitute for the new high risk pool. Those who are already in CHANDS will keep their coverage. To qualify for the new program, a person would have to have a pre-existing condition and have been without insurance for at least six months.
Hamm said it’s not clear how the insurance would be administered. The roughly 1,500 people in CHANDS receive service through Blue Cross Blue Shield.
After 2013, states will be able to chose whether they want to continue running any type of high risk pool program.
“When you look at the big picture, when you analyze it completely, it comes back to what happens if the money runs out,” Hamm said. “And there wasn’t a legitimate answer from the federal government for that.”