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Indiana's Fund for High-Risk Health Care Faces Funding Crisis

May 7, 2001

Indiana's health care fund for so-called uninsurable residents is running debts so large that HMOs and insurers are struggling to meet a state mandate to pick up the tab. In the past three years, the deficit to provide medical care to AIDS patients, hemophiliacs and others in the high-risk pool has jumped from $17 million to $43 million. This year, the premium gap could top $60 million, the Indianapolis Star reported yesterday.

The Indiana Comprehensive Health Insurance Association (ICHIA) is a quasi-public program that offers health insurance to the non-poor under age 65. To sign up, a person must have been turned down for private insurance because she or he suffers from a pre-existing problem like AIDS or cancer. Program users are often self-employed, too young for Medicare and not poor enough for Medicaid. For 20 years, the state's private insurers have diverted the high-risk population to the pool and collectively kicked in the subsidies necessary to cover costs. The state allowed the companies dollar-for-dollar tax credits against their assessments, allowing them to run the pool at no real cost to themselves.

But new challenges have confronted the plan during the past two years. To save money in its federally funded uninsurable program, the state Department of Health dumped more than 1,000 AIDS patients, hemophiliacs and others into the ICHIA, raising its enrollment from 4,200 in 1998 to 7,000 today. Even though they are shared among 400 health companies, assessments have run so high they often cannot be offset by state tax credits, according to Indiana's health insurance industry. State-based HMOs have been hardest hit. More than half of the health insurance business in Indiana-mainly self-insured employer groups-is federally exempt from paying assessments into the pool, leaving non-exempt insurers and HMOs bearing disproportionately heavy assessments.


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Adapted from:
Associated Press; 05.06.01



  
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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
 

 

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