Saturday, May 1, 2010

TN nonprofit could run program for uninsurable residents

Tennessee won't be operating a new high-risk pool for uninsurable residents set to go into effect in July under federal health-care reform, but those eligible across the state would still have access to a new national pool program.
The state instead has recommended that federal authorities work with a nonprofit entity here to carry out and run a new pool that would offer health coverage to people who have been uninsured during the previous six months because of pre-existing medical conditions.

The pools are meant to be a temporary solution that would provide coverage at rates similar to what most consumers pay until health-insurance exchanges envisioned as part of the health-care reform are set up by 2014, giving high-risk consumers a place to shop for coverage.

States had to inform federal officials by Friday whether they planned to run a new pool alongside their current high-risk pool programs, build upon other existing programs, suggest that a nonprofit entity run the new pool, or allow the U.S. Department of Health and Human Services to operate a coverage program.

Gov. Phil Bredesen told federal officials that Tennessee opted not to combine the new program with its existing AccessTN high-risk pool or run a second new program because differences in benefits, premium levels, funding and eligibility requirements would have made it difficult to coordinate the programs.

"It's a lot of work to set it up; it's a short period of time; it doesn't really fit with what we're doing right now," Bredesen said in an interview about the decision. "If this is one where somebody else at no disadvantage to Tennesseans can just take the problem off our hands, that's a good solution."

Tony Garr, who runs the advocacy group Tennessee Health Care Campaign and had favored expanding AccessTN, said he was baffled and shocked by the state's decision.

"The current program, AccessTN, provides good coverage, is well managed and having some extra funds to expand that to cover more people and make it more affordable would have made better sense," he said. "Setting up a separate entity that essentially does the same function for people who are uninsurable because of pre-existing conditions, it just complicates the ability of people to obtain coverage."

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