Insurers Reopen Coverage ‘High-Risk Pool’ Returns To Area To Alleviate Health Insurance Shortfall

State medical insurance carriers have agreed to reopen a special health insurance pool to help make coverage more readily available in 15 Eastern Washington counties, Insurance Commissioner Deborah Senn said Thursday.

But the move likely will do little to ease the shortage of insurance coverage in counties where virtually all insurers have pulled out because of high costs, said Basil Badley, a top insurance industry lobbyist.

However, Senn’s chief deputy, Robert Harkins, said reopening the industry’s “high-risk pool” is especially timely.

Four insurers recently said they no longer would offer the unsubsidized version of the state’s Basic Health Plan, leaving more than 3,000 people, many in rural areas, scrambling for coverage, Harkins said. Another five insurers said they would freeze enrollment in the unsubsidized Basic Health Plan through next year.

The much larger subsidized Basic Health Plan - with state subsidies based on the subscriber’s income - is not affected.

Harkins said administrators of the pool plan will start taking applications for the program, which will be available through the commissioner’s office next week.

Policies could be in force as soon as Oct. 1.

Harkins said premiums could be lower than those for the Basic Health Plan and the benefits could be richer, depending on the age of the applicants.

But generally, he said, costs will be higher.

“This is not going to be a perfect solution,” he said.

Harkins estimated that about 2,500 residents of the 15-county area might take advantage of the coverage.

“For those people, they need options, and this gives them one more,” he said.

There was hope the pool could develop a managed-care option to reduce the cost, but Badley said it is unlikely insurers will go along because “managed care doesn’t work in small towns.”

The 12-year-old high-risk pool, which has been closed for several years, was designed by the industry for people with severe or chronic conditions who could not get insurance elsewhere.

The pool was closed after 1993 legislation guaranteeing all Washington citizens insurance coverage.

Reopening the pool has been urged by consumer groups and others who successfully opposed a legislative measure this year that would have tightened the 1993 rules giving subscribers considerable freedom to switch from plan to plan or to subscribe only when they need health care.

Insurers blame those rules for their inability to offer coverage in the 15 Eastern Washington counties - Adams, Benton, Chelan, Douglas, Ferry, Franklin, Garfield, Grant, Kittitas, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens and Whitman.

The subsidized version of the Basic Health Plan has about 130,000 working poor on its rolls. In the unsubsidized version, subscribers pay full cost for the same bare-bones coverage.

A CLOSER LOOK SPECIAL COVERAGE Robert Harkins, chief deputy to Insurance Commissioner Deborah Senn, estimated that about 2,500 residents of the 15-county area might take advantage of the special health coverage. To obtain an application for the high-risk coverage, call 1-800-562-6900.