Low enrollment in the high risk pool

As several media organizations noted over the holidays Inclusive Health, our state’s high risk insurance pool began offering coverage on Jan. 1 to people who can’t get insurance on the private market. So far the pool has only approved a couple of hundred people for coverage.

The low enrollment is not that surprising. There has not been much of a marketing effort. Media stories have helped but I haven’t heard radio ads or seen billboards. Advertising and aggressive outreach is especially important because eligibility if fairly complex. If we created a program that covered all parents, for example, then it would be easy for people to know if they qualify. If you are a parent you can get insurance. With the high risk pool there is a list of qualifying conditions with exceptions and exemptions; private insurance companies tried to narrow the pool as much as possible so that it would not poach potential customers.

Also, the pool is still expensive. Many people who join the pool would pay $1,000 per month or more for health insurance on the private market, so the state program is certainly less expensive. But $500 per month is still out of reach for many people.

The high risk pool is a good and necessary step for North Carolina. But enrollment in similar programs across the country vary from around 5,000 to 30,000. Our pool might end up with 10,000 to 20,000. Currently there are about 1.5 million people without insurance in our state. Even an unusually robust high risk pool will barely make a dent.

Now that unemployment in North Carolina is creeping toward double-digits I’m afraid that we are going to be flooded with newly uninsured residents. Before the current economic crisis people in our state were losing employer-sponsored health insurance at double the national rate.

If the soon-to-convene session of the General Assembly concludes and we have no new programs to offer the uninsured then the high risk pool will be like standing at the edge of a California wildfire and throwing water one bucket at a time.