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Washington state to launch high-risk insurance program

Fri., April 30, 2010, 12:22 p.m.

Washington is set to start a new federally funded high-risk health insurance program.

It is designed to cover people who are unable to obtain insurance, such as former and current cancer patients.

The state’s program will serve as a 3 ½-year coverage bridge until federal health insurance reforms passed this spring take hold Jan. 1, 2014.

No state funds will be used, said Stephanie Marquis, a spokeswoman for the Washington state Office of the Insurance Commissioner.

Instead, the state expects $102 million in federal dollars to fund the insurance coverage. Residents enrolling in the high-risk program will pay premiums, although those amounts have yet to be determined.

“We’re talking about people who have tried to buy coverage in the private market … but were screened out because of a pre-existing condition,” Marquis said.

Insurance regulators are unsure how many people may qualify. As of Friday there were about 843,700 uninsured state residents, including nearly 78,000 children.

State officials decided to run their own high-risk pool program rather than turn to the federal government to manage one on its behalf. It will begin July 1.

To be eligible for the high-risk pool, a person must be a U.S. citizen or reside legally in the country; have been uninsured for six months; and have a pre-existing condition.

The state will manage the program, encouraged by its experience with the Washington State Health Insurance Program (WSHIP).

That state program was created 23 years ago and is managed by a private nonprofit organization. It was established to provide coverage for the highest-risk residents. There are currently 3,578 people enrolled in WSHIP, which is funded through patient premiums and a fees charged to health insurers doing business in the state.

WSHIP also will cease in 2014 when the federal reforms take hold and outlaw coverage denials for people with pre-existing conditions.

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