KHI News Service

Changes to Kansas high-risk pool recommended

By Phil Cauthon | January 26, 2011

A Senate committee today endorsed three proposed changes to the state’s high-risk pool, a subsidized insurance program for people with pre-existing medical conditions who otherwise could not find or afford coverage.

The three changes — proposed by the Kansas Insurance Department in Senate Bill 14 — are needed to improve or expand the pool's coverage, said Kevin Davis testifying for the department.

The proposed modifications are:

• Raise the pool's lifetime benefit limit from $2 million to $3 million. Davis said the limit was raised once before in 2007 from $1 million, but one person reached the maximum this Christmas and now has no coverage. Another of the pool’s 1,732 enrollees has received $1.3 million in benefits. The bill also would allow the pool's administrators to increase the lifetime benefit subject to approval by the state insurance commissioner. Currently, the limit only can be increased by changing state law.

• Allow the pool to provide individual policies for children under the age of 19 who cannot obtain private coverage in the county where they reside. Davis said most insurance companies in Kansas have withdrawn or plan to drop individual policies for children under 19.

• Children under age 19 could not be excluded from pool coverage due to a pre-existing conditions.

Davis said that in 2010 the pool paid $27.2 million in benefits and collected $12.5 million in premiums. The pool is funded by premiums paid by enrollees and by assessments on the health insurance companies operating in the state. The changes could increase premiums and/or assessments, he said.

It is expected that the pool won't be necessary after 2014, when the major coverage provisions of the federal health reform law become effective. Then, people in the pool should be able to find insurance through exchanges regardless of their conditions.

The bill passed the committee unanimously and can advance to the full Senate for consideration.