Health Reform Reality Kicks In: Costs Still High

Women in Poverty - Tales from the Recession's Front Lines

Part: 11

Health Reform Reality Kicks In: Costs Still High

By Sharon Johnson

WeNews senior correspondent

Thursday, September 2, 2010

Coverage of people with pre-existing conditions was supposed to help women in particular, who suffer more chronic illness. But as the "high-risk pools" take effect, low-income women may have a harder time paying the premiums.

20-dollar bills (WOMENSENEWS)--Antoinette Kraus worries that some eligible women may not tap the new insurance pools that have started taking effect for people with pre-existing conditions in the first phase of health reform.

"Uninsured people are difficult to reach," said Kraus, lead organizer with the Philadelphia Unemployment Project, a longstanding advocacy group for low-income and unemployed people. "A single, unemployed woman who lives alone and only seeks medical care when she has a health emergency may be unaware that she could qualify for a policy that would give her access to physician visits, medications and other treatments she needs to stay healthy."

The Congressional Budget Office estimates that as many as 4 million individuals are eligible for coverage, but only 3,600 women and men applied during July, the first month of operation of the high risk pools. The Department of Health and Human Services predicts that 200,000 to 400,000 will enroll over the next three years.

But the problem of accessing the new pools may go beyond public awareness. For many low-income women the insurance may simply cost too much.

During the battles over health care financing overhaul, advocates for women's health strongly supported these "high-risk pools" since they would help people with chronic conditions such as multiple sclerosis, rheumatoid arthritis and diabetes, which afflict more women than men. Their focus, however, was on 2014, when insurance companies will no longer be permitted to deny coverage based on medical history and states would create exchanges where people will shop for coverage and be eligible for financial aid to pay premiums.

The stop-gap, four-year program now taking effect with a total federal budget of $5 billion was left largely on the sidelines.

Higher Premium Charges Not Allowed

By law, the transitional high-risk pools cannot charge higher premiums than the standard premiums for healthy people in the state.

"This is an improvement because people who applied for insurance in the individual market often had to pay 125 percent of the standard premiums or more," said Julie Sonier, deputy director of the State Health Access Data Assistance Center, a research organization of the School of Public Health of the University of Minnesota in Minneapolis-St. Paul. "But the premiums may still be too high. Unlike Medicaid, eligibility for the high-risk pools is not based on income."

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