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Pawlenty’s path the road less traveled; Most states to run high-risk pools

While Gov.

WASHINGTON — A quick follow-up to Friday’s post about Gov. Tim Pawlenty opting Minnesota out of creating a new health insurance pool for high-risk enrollees under the new health reform law, instead choosing to let the federal government form and operate it. 

Pawlenty, in letter Friday to Health and Human Services Secretary Janet Napolitano opting out, said he doubted the $68 million the federal government has set aside to help cover the risk in Minnesota’s high-risk pool likely would be enough.

However, most of the 43 states to respond so far have come to a different conclusion, agreeing by about a two-to-one margin to run their own pools. 

“We value the input of our state partners and are heartened by the strong show of support we have seen already for getting the critical benefits of the Affordable Care Act to the American people as quickly as possible,” said Jenny Backus, spokeswoman for the Department of Health and Human Services. “This is a very state-friendly law that is designed to give states important resources and flexibility to implement the new law.”

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The pools are designed to be a bridge to 2014, when much of the law takes effect. The state pools can be managed a number of ways, four of which involve state control. According to HHS, states’ choices were:

  • Operate a new high risk pool alongside a current state high risk pool;
  • Establish a new high risk pool (not an option for Minnesota because we have an existing pool);
  • Build upon other existing coverage programs designed to cover high risk individuals;
  • Contract with a current HIPAA carrier of last resort or other carrier, to provide subsidized coverage for the eligible population; or
  • (Pawlenty’s pick) Do nothing, in which case HHS would carry out a coverage program in the state.

An interesting political aside: Twelve of the 15 states to opt out have Republican governors, while 21 of the 28 that will operate their own pools have Democratic governors.