Hard-to-insure New Mexicans will now have access to a federal high-risk insurance pool that could cover 1,000 to 1,500 New Mexicans who’ve gone without coverage for six months and have been unable to buy insurance, often because of preexisting conditions.
The federal high-risk pool will supplement a similar program the state has offered for decades, the New Mexico Medical Insurance Pool.
“New Mexico is pleased to be able to offer another option of affordable health coverage through the new federal high-risk insurance pool program,” Gov. Bill Richardson was quoted as saying in a news release sent out Thursday announcing the federal high-risk pool.
“We are fortunate to have a good existing high-risk pool that will now use federal funds to expand its services to more New Mexicans,” Richardson said.
Individuals enrolling this month in the new federal high-risk pool can expect their coverage to begin Aug. 1, according to the news release. A low-income person who enrolls in the federal high-risk pool may qualify for a subsidized premium.
The temporary federal high-risk pool expires in 2014, when many provisions of the new federal law take effect, including one that prohibits health insurers from denying insurance coverage for medical reasons.
The state’s high-risk pool — the New Mexico Medical Insurance Pool — had more than 7,800 New Mexicans enrolled at the end of 2009. But those individuals can’t jump to the federal program because participants in the new high risk pool must have been uninsured for the past six months.
The federal high-risk pool can insure a limited number of New Mexicans because the new federal health care law only appropriated $37 million to the state over three years to fund the program.
But $37 million – or a little over $12 million a year – isn’t a lot of money for a pool that serves individuals that can’t get insurance in the private-sector either because of preexisting conditions or serious illness, state officials have said.
For example, the state’s high-risk pool, like its federal counterpart, is a last-resort shelter for the participants who aren’t insurable in the private insurance markets. As a result the state’s high-risk pool paid out $88 million in medical and pharmacy claims in 2009, compared to the $19.8 million it took in premiums.
State officials have said that they hope to lobby the state’s congressional delegation to increase the funding for the federal high-risk pool.