Nevada is the third state to officially opt-out of the interim high-risk pool program put forward in the new health care law, paving the way for the federal government to enroll uninsured state residents in a federal high risk pool program. The health care law established the pools as an interim measure to provide coverage for Americans with pre-existing conditions until the exchanges become operational in 2014. States that fail to build upon their existing programs or establish new pools will cede control to the federal government. Georgia does not currently operate such a program.
In a letter to HHS Secretary Kathleen Sebelius, Gov. Jim Gibbons (R) blamed the feds for not providing enough money for the pools:
In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, Gibbons said the estimated $61 million Nevada would receive to implement the pool under the recently signed federal health reform bill would be “grossly inadequate” to serve as many as 100,000 people who may be eligible.
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“We estimate Nevada’s share of the $5 billion national pool will only allow approximately 2,900 individuals to be served,” Gibbons wrote, adding that more than 500,000 Nevadans are uninsured and an estimated 100,000 may be eligible to join the pool. “We do not believe financial or human resources are available to manage the pool,” the governor wrote. “There will be a significant problem managing the few who become eligible, but an even larger problem managing the frustration of people not eligible for the pool.”
Gibbons isn’t wrong to argue that the federal government will probably need to put more money towards the program, but the sentiment seems to contradict the often repeated Republican claim that the federal government should stay out of the health care business altogether. In fact, the three other states that have chosen not to build their own pools or embellish their existing programs — Georgia, Louisiana, and Nebraska — have all portrayed the federal health care law as a grotesque abuse of federal power. Earlier this month, Gibbons even signed an “executive order appointing a Las Vegas attorney to represent Nevada in a multistate lawsuit filed in Florida challenging the constitutionality of the law after Democratic Attorney General Catherine Cortez Masto refused.” Now, he’s relying on the federal government to cover the uninsurable population, helping bring about the very thing he fears — greater government involvement in the health care sector.
Sen. John McCain (R-AZ) initially proposed state-based high-risk pools as a way to cover Americans with pre-existing conditions during the presidential campaign (conservative organizations like the Heritage Foundation seem to support the idea as well) and was heavily criticized by Democrats for underfunding the initiative. Now that Obama has accepted the idea into health reform, Republicans are taking their swings and opting out of McCain’s idea.
States have until Friday to tell the federal government if they will voluntarily establish or build upon an existing state-based high-risk pool program.