 The 16,000 residents who already pay into Illinois' high-risk health
insurance pool will keep paying high rates, while others who enroll
this summer under a new, similar program will get coverage at much
lower, more reasonable prices.Illinois is among the states that
have told the federal government they want to take part in the new
high-risk pool program, an early component of the U.S. health care
overhaul law. Illinois hopes to start enrolling people in the new
program in July.
The federal government has $5 billion for the state pools, which
will help people with pre-existing conditions get coverage until
2014, when insurance companies will no longer be able to deny them
coverage. The law requires that the new, temporary pools charge no
more than standard rates.
But only people who have been uninsured for six months are
eligible -- meaning those in the current state pool can't switch and
save.
Julie Kramer, 53, is feeling a bit cheated. She's paid high
premiums -- about $700 a month -- for nearly seven years into
Illinois' high-risk pool.
"It feels very unfair. It goes against the spirit of what health
care reform was supposed to be," said Kramer, a self-employed writer
and owner of Full Moon Marketing Communications in Vernon Hills.
"This does seem like a low blow."
The existing program is called the Illinois Comprehensive Health
Insurance Plan, ICHIP. Thirty-four other states have similar
programs.
By state law, people in ICHIP pay 25-50 percent more than
standard rates. The average annual premium has increased about 20
percent over the past five years. A 62-year-old woman now pays about
$1,000 a month for a plan with a $500 deductible.
Premiums depend on the size of the deductible, where the enrollee
lives, gender and age. The average annual claim cost per enrollee
was $10,433 last year. Premiums pay for about 60 percent of the $174
million program. An assessment on insurers contributes about 23
percent and the rest comes from state and federal money.
Kramer's deductible, which she has to pay out of pocket before
insurance kicks in, is $1,000. Last year, her medical expenses
didn't reach that amount, so she paid all her medical bills herself.
Illinois Department of Insurance Director Michael McRaith
understands Kramer's frustrations. To even the playing field, he
said, the state Legislature would have to act to reduce ICHIP
premiums and achieve what he called "premium fairness."
"I and the board of directors for ICHIP and Gov. (Pat) Quinn are
very supportive of the current enrollees and share the concern of
the current enrollees," McRaith said. "We want to be as fair to the
current enrollees as possible."
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Illinois expects to receive nearly $200 million from the federal
government to start the new high-risk pool. The insurance department
estimates that would be enough to cover about 5,000 people in the
new plan, McRaith said.
That's far fewer than the number of people who may qualify. A
2008 U.S. Government Accountability Office report said about 218,000
people might be eligible for a high-risk pool in Illinois.
On the ICHIP website, a letter to enrollees explains "it's
unlikely that the federal funds will be available to reduce premiums
paid by current ICHIP enrollees."
The letter hasn't been mailed because the program can't afford
the $5,000 postage.
"We have not mailed that letter," McRaith acknowledged. "The cost
of mailing was prohibitive given that we have at this point not
received the (federal) funding. It would be inappropriate to
withdraw funds to send a letter."
Kramer read the letter on the website after being told about it
by a reporter.
"I did feel a little flash of anger and disappointment when I
read it," she said.
___
On the Net:
http://www.chip.state.il.us/
[Associated Press;
By CARLA K. JOHNSON]
Johnson is an AP medical writer.
Copyright 2010 The Associated Press. All rights reserved. This
material may not be published, broadcast, rewritten or
redistributed.
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