CBO forecasts tough choices ahead for high-risk pool program

Healthcare reform's high-risk insurance pools could end up excluding hundreds of thousands of Americans or costing three times more than what's budgeted now, the Congressional Budget Office said Monday. In a letter sent Monday to Senate Health, Education, Labor and Pensions (HELP) Committee ranking Republican Mike Enzi (R-Wyo.), CBO Director Doug Elmendorf laid out the stark choices facing a program that's meant to help cover sick Americans until the nation's healthcare system is overhauled in 2014.

The program's $5 billion budget will probably run out before 2013, Elmendorf writes. Extending it until 2014 to the 600,000 to 700,000 eligible Americans who are likely to enroll by then would cost an extra $5 to $10 billion, for a total of $10 to $15 billion. Several million people would be eligible for the program, he adds, but most are not likely to enroll.

Health and Human Services Secretary Kathleen Sebelius also has the authority to cap enrollment.

"On that basis, CBO expects that the number of enrollees in the program will average about 200,000 over the 2011-2013 period," Elmendorf wrote. "If, instead, more people are allowed to sign up initially, the available funds will probably be exhausted prior to 2013, but total spending for the program will still be capped at $5 billion."

Republicans are already latching onto the CBO's analysis. The office of Rep. Dave Camp (Mich.), senior Republican on the Ways and Means Committee, shot out a statement Monday night blasting Democrats for selling their health reform law with "false promises."

This post was updated June 21st at 7:35 p.m.