KANSAS CITY, Mo. – The Kansas Senate will be considering changes to the state's high risk insurance program today. The program, which is separate from the new federal high risk pool, is designed for people who can't get health insurance in the private market due to a pre-existing health condition.
Senate Bill 14 would allow children to enroll in the pool even if they have not been denied coverage elsewhere. Kansas Insurance Commissioner Sandy Praeger says her department is proposing the change in eligibility because insurance companies recently stopped selling child-only health plans.
"Our existing high risk pool says you can't be eligible for coverage unless you've been declined coverage in the market. Well, you can't be declined coverage if it isn't offered," says Praeger.
The absence of child-only policies in most parts of the state is a new phenomenon. Insurance companies stopped selling the child-only policies last fall, when a provision of the federal health law took effect, barring companies from denying children health coverage. The rule kicks in for everyone in 2014.
Child-only health plans are not very popular, but Praeger says they're an important option for kids who don't have access to insurance through their parents or qualify for other options like Medicaid.
Mary Beth Chambers is with Blue Cross of Kansas, the largest insurer in the state. She says the company stopped offering the child-only plans out of concerns that families might wait until a child gets sick and needs costly medical care before signing up for coverage.
"Having the guarantee issue for kids under the age of 19 without any sort of mandate for all kids under the age of 19 to have insurance was just going to pose a huge risk," Chambers says."The premiums you're going to be able to get from those products is unlikely to be able to cover the cost of the claim."
Chambers says Blue Cross of Kansas will still provide coverage to the 2,100 kids who are already enrolled in their child-only policies.
Blue Cross Blue Shield of Kansas City (which is separate from Blue Cross of Kansas) is the only company in either Kansas or Missouri that still sells child-only health plans.
"We did so because it was the right thing to do," says Blue Cross spokesperson Sue Johnson.
SB14 unanimously passed out of a Kansas senate committee last week. Besides changing the high risk pool's eligibility requirements for children, the bill would also raise the pool's cap on lifetime benefits. The insurance department is recommending the change because a few people have already reached the current coverage limit.
Unlike Kansas, Missouri does not require that a person be rejected from a private health plan in order to be eligible for the state's high risk pool.
*UPDATE (02/11/11): The Senate unanimously passed the bill. The House introduced the legislation and referred it to committee.
Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.
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