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Georgia Backs Out of New Law's High-Risk Insurance Pool

By Jane Norman, CQ HealthBeat Associate Editor

April 12, 2010 -- The state of Georgia will not establish a high-risk pool to provide health insurance coverage for people with pre-existing conditions, the state's insurance commissioner announced Monday.

Commissioner John Oxendine said in a statement that he was concerned that the state could become financially responsible at some point for the pool, though the program is envisioned as temporary under the new health care law (PL 111-148). The high-risk pools are supposed to be funded by grants made to states.

"I have no confidence in any federal assertion that this so-called temporary program will not burden the taxpayers of Georgia," he said in a statement. "I am concerned that the high-risk insurance program will ultimately become the financial responsibility of Georgians at a time when our state is furloughing teachers, laying off employees, and cutting public safety and education funding."

The reaction comes from a state where Republican lawmakers have been particularly outspoken about their opposition to the new law.

Oxendine, a Republican, is running for governor and is an advocate of challenging the law's constitutionality. Georgia Gov. Sonny Perdue, also a Republican, recently announced the state would join 18 other states in a legal challenge. He vowed to use private lawyers after the state's Democratic attorney general refused to join the suit.

Health and Human Services Secretary Kathleen Sebelius wrote to states on April 2 asking what their interest would be in extending insurance through high-risk pools to people with pre-existing conditions who have lacked insurance for at least six months. The $5 billion program is intended to be temporary until 2014, when insurance companies will be required to accept all comers regardless of their health status.

If Georgia declines to participate, the federal government can directly set up a pool under the law so the uninsured have an option, said Jeanne Lambrew, director of the Health and Human Services Department's Office of Health Reform.

"For too long, people with pre-existing conditions have been locked out of the insurance market, including some people in Georgia," Lambrew said. "If state officials in Georgia elect not to participate in the high-risk program, our department will work to ensure that people in Georgia as well as other states that don't participate have access to affordable insurance."

Oxendine blasted what he called a "federal takeover" of the health care system. "The new federal health care legislation was hastily drafted behind closed doors and passed as a result of numerous back room deals in defiance of the will of a majority of the American people," he wrote in a letter to Sebelius.

Currently 35 states run high-risk pools, though not all are accepting new members, and they serve about 200,000 people. Often the premiums are very expensive. Premiums would be cheaper in the new program because of the federal subsidy.

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