Funding High-Risk Pools: Changes, Trends and Policy Concerns

 

Prepared by the National Conference of State Legislatures for the Blue Cross and Blue Shield Association
June 2005

Author: Kala Ladenheim

 Download the full document (56 pages)

Researchers at the National Conference of State Legislatures surveyed medical high-risk pool administrators in 33 states in order to learn how policy makers perceive current state policy and proposals related to risk pool funding, and how funding is being affected by the changing state and Federal fiscal and policy environments. To provide a more nuanced understanding of the national results, case studies were conducted in six states (Colorado, Illinois, Indiana, Kentucky, Minnesota and South Dakota) selected for their varied histories, concerns and pool memberships.

• Part 1: Survey Highlights: Role of Risk Pools
• Part 2: Survey Results: Funding Nuts and Bolts
  • Introduction
  • The Project
  • Historical Overview
    • ERISA and Market Changes Impact Funding
    • Impact of Federal Policies on Risk Pools
  • Approaches to Funding
    • Premiums
    • Premium Subsidies Based on Income
    • Payment by Third Parties
    • Carrier Assessments
    • Assessment with Tax Offsets
    • Alternative Assessment Approaches
    • State Appropriations
    • Unpredictable Funding
    • Dedicated Revenue
    • Provider Assessment or Discount
  • Pool Operations
    • Timing and Independence
• Part 3: Case Studies - Evolution in Funding Strategy
  • Colorado
  • Illinois
  • Indiana
  • Kentucky
  • Minnesota
  • South Dakota
• Part 4: Looking Ahead
  • State Financing Policies Must Co-Exist with Budget Limits
• Bibliography
• State Case Study Resources
• Appendices
• End Notes

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