Guv worries about cost of high-risk health insurance pool

Published April 28, 2010 5:59 pm
Politics» Herbert says program looks like an unfunded federal mandate.
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Utah isn't ready to dive into a temporary high-risk insurance pool created through the new health reform law until it gets some assurances the federal government will cover the costs.

Gov. Gary Herbert sent a letter Wednesday to Health Secretary Kathleen Sebelius questioning the financial feasibility of the $5 billion program, which is supposed to kick in at the start of July.

"I have strong concerns that the program is severely underfunded and will ultimately result in yet another unfunded mandate on our state," he wrote.

State leaders have two options: they can take an estimated $40 million and manage the program or the federal government will step in and run it. Sebelius was hoping for an answer by Friday, though Herbert asked for more information before he made up his mind.

"Regardless of what a state decides, the bottom line for the American people is the same: uninsured Americans with pre-existing conditions will have access to affordable insurance," said Jessica Santillow, spokeswoman for Health and Human Services.

Herbert's concerns stem from a non-partisan analysis by the chief actuary at the Center for Medicare and Medicaid Services. In a recent report, he estimated the $5 billion allotted for the high-risk pool wouldn't last through the end of 2012, even though the temporary program is supposed to exist until 2014.

The actuary said the health reform law would raise federal health costs, not lower them, which was a stated goal of the president.

Congress designed the temporary pool to offer affordable coverage to people deemed uninsurable until a new marketplace is created in 2014 that would cover all who apply.

If Utah elects to run the program Herbert worries the state may get stuck footing the rest of the bill, which he said would be difficult because of the nationwide recession.

"Please help me, as governor, assure Utahns that their federal government will be fiscally responsible for the costs associated with the laws it passes," he wrote to Sebelius.

Utah's elected leaders opposed the health reform bill and recently Attorney General Mark Shurtleff signed onto a lawsuit challenging the constitutionality of some of its provisions.

Sen. Orrin Hatch, R-Utah, a leading critic of the new wide-ranging law, shared Herbert's concern.

"At a time of sky-high budget deficits, it's critically important for the people of my state to understand whether the $5 billion that was included for this temporary high-risk pool program will be enough," Hatch said, "and if not who will be footing the bill."

Utah has its own high-risk pool that covers 3,700 people with disabilities and chronic illnesses. That pool, known as HIPUtah, doesn't meet all of the new federal requirements. State House Speaker Dave Clark said Utah may need a legislative special session in May or June to either tweak the existing program or create a new side-by-side program if the state decides to participate.

"We are considering our options and we need additional information from HHS before we make that decision," said Herbert's spokeswoman Angie Welling.


Guv fears cost of high-risk pool

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