Obamacare Program for Uninsured Failing in Many States

One of the main pillars of the Obama administration’s massive healthcare law — the special plans devoted to those unable to obtain insurance through normal means — is attracting only a small fraction of what was expected. The result is that the program may end up costing taxpayers far more than the $5 billion originally set aside, according to The Washington Post.

One reason for the reluctance of consumers to sign up for the plans, collectively known as the Pre-Existing Condition Insurance Plan, is that they are far more expensive than alternatives the uninsured might find elsewhere, the Post is reporting. Since the plans opened in the late summer and early fall, the medical bills in some states are much higher than anticipated.

The reason is that if fewer people sign up, the costs cannot be defrayed over a huge number of people paying into them.

The plans, known as high-risk pools, will take time to adjust prices and benefits, federal officials tell the Post. But since last spring, when Medicare program's chief actuary predicted that 375,000 people would sign up by the end of 2010, only 8,000 have enrolled, according to the Health and Human Services Department. Nationally, there are some 50 million uninsured who, in theory, should benefit from the plans.

State-level directors of the plans say that the insurance premiums are unaffordable for many who need the coverage. Potential clients are also concerned about the plans' stability as federal lawsuits and congressional Republicans are trying to overturn the entire law.

The failure of the pools also could also cripple the planned changes in health insurance by 2014, when states are to open new marketplaces — or exchanges — for Americans to buy coverage individually or in small groups.

Twenty-three states have created their own high-risk pools. The rest used an option in the law to let their residents buy coverage through a new federal health plan. HHS officials refused to provide an update to the Post, although they collect such figures monthly, because they have decided to report them on a quarterly basis.

"Like the rest of the country, we thought we'd have pretty much a stampede. That obviously hasn't materialized," said Michael Keough, executive director of North Carolina's plan. With nearly 700 participants, it is among the nation's largest so far, but it has one-third of the people expected by now.

The numbers signing up for the plans in many states are downright miniscule. According to interviews with administrators of nine of the state-run plans, only one — Colorado's — is close to its forecast enrollment.

Maryland, the only jurisdiction in the Washington area that has created a plan, has 97 participants, compared with 1,900 in an older state high-risk pool. HHS' November report said that Virginia had 75 participants in the federal plan and the District had none.