But in the face of initial enrollment figures that fell far short of expectations, HHS said Tuesday that enrollment in a high-risk pool will no longer require a rejection from a private company. The plans will now accept a note from a doctor saying the person has or has had a medical condition within the past year.
HHS runs high-risk pools in 23 states; the rest are state-based.
In addition to easing enrollment criteria, the department said it would lower premiums in 18 of those 23 states to bring them more in line with the average cost of an individual plan there. The high-risk pools’ low enrollment was attributed in part to the high cost of the plans — which, by design, cover only the most expensive patients.
Department officials said the federal government — not states — would pick up the extra costs after premiums decline. They could not provide an estimate of how much the changes will cost.
The high-risk pools received $5 billion in funding through the healthcare reform law. Both the program and its funding are scheduled to end in 2014.