Despite Obamacare, High-Risk Insurance Pools Stay Afloat
Rob Nikolewski /
SANTA FE, N.M.—Earlier this year, the board that runs New Mexico’s high-risk insurance pool agreed to pay up to $600,000 to an Albuquerque consulting group to handle day-to-day operations of the pool, which was designed to offer insurance to people who had trouble getting coverage.
But wasn’t the Affordable Care Act supposed to make high-risk insurance pools obsolete?
“I’ve been asking that for two years,” John Franchini, the New Mexico Superintendent of Insurance, said with a laugh. “I do know the federal Affordable Care Act says all these pools should be dissolved. But we have a problem in New Mexico. We have a statute that created the New Mexico Medical Insurance Pool, and since that statute is active and in place, we have to make sure we don’t violate that.”
Franchini said his office is working on legislation to limit the pool’s population.
There are currently 5,600 patients in the New Mexico Medical Insurance Pool, Franchini said, compared to about 10,000 at the beginning of last year.
Franchini said he’d like to see the numbers reduced to “no more than 1,000.”
But if Obamacare, as the law is known, prohibits insurance companies from denying patients with pre-existing medical conditions, why does the pool still exist?
“I think the answer is not every New Mexican can avail themselves of the Obamacare system,” said Gabriel Parra, staff attorney for Presbyterian Healthcare Services and a member of the NMMIP board. “We didn’t want to put New Mexicans at risk by kicking them out of the pool, and we wanted to do that in a more thoughtful way.”
New Mexico isn’t alone.
According to the National Association of State Comprehensive Health Insurance Plans, 35 states had high-risk insurance plans before Obamacare went into effect.
Of those, 12 states have eliminated their pools and six are the process of shutting them down, but 17 other states haven’t made any specific plans to eliminate their pools.