Federal option for uninsurable Utahns closing early

Health reform • Amid fears funding won't last, high-risk pool stops eight months early.
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The federal government is halting enrollment in its high-risk pools, subsidized health coverage for people rejected by private insurers because they're too sick.

The program was meant as a stop-gap for the uninsurable, to last until Jan. 1, 2014, when insurers will be prohibited from turning down people with pre-existing health conditions.

But funding for the $5 billion program is running out, explained Tomi Ossana, who helps administer the program for Utah.

Capping the program now is a means to ensure there's enough money to pay the medical bills of those already enrolled — including 1,400 Utahns, she explained.

In Utah the risk pool — Federal-HIPUtah — will stop accepting applications on Saturday at 11:59 p.m.

But the state's own risk pool, HIPUtah, will remain open indefinitely. The program operates under different eligibility rules and coverage isn't as heavily subsidized, but it's larger, serving 3,400 men, women and children.

Both pools require hefty monthly premiums from clients.

Officials expect to transition the HIPUtah individuals into health insurance exchange markets in October, assuming the markets are open for business by then, said Ossana. "But there are a lot of unknowns … so we're just kind of keeping our options open."

To keep some HIPUtah clients covered through the transition, an omnibus health reform bill, sponsored by Rep. Jim Dunnigan, R-Taylorsville, proposes raising HIPUtah's lifetime benefits ceiling for individuals to $1.8 million from $1.5 million.

kstewart@sltrib.com —

Coverage for the uninsurable

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