In anticipation of the new federal high-risk insurance plan approved under health care reform, Tennessee's own state-run high-risk pool will stop accepting new members this month.
The AccessTN board of directors voted last week to close the health insurance plan to new members starting Oct. 15, according to a news release.
The program's 4,000 current members won't be affected, and those who already have applied for coverage still will be able to enroll if approved.
Gov. Phil Bredesen created AccessTN in 2007 as part of the Cover Tennessee health initiative to provide a coverage option for uninsurable Tennesseans with pre-existing conditions.
The new federal plan has allocated $97 million for those uninsurable Tennesseans.
"This represents a tremendous opportunity for those in our state who need health insurance but cannot enroll in private plans," Bredesen said in the release.
The federal plan, called the Pre-Existing Condition Insurance Plan, is administered by the U.S. Department of Health and Human Services. Applicants must prove that they have been denied insurance from a private insurer and have been without health insurance for at least six months, according to HealthCare.gov, the federal website to inform the public about the health care reform law.
AccessTN will continue to exist until 2013, when health reform is fully implemented and insurers no longer will be able to deny insurance based on pre-existing conditions, said Joe Burchfield, spokesman for Cover Tennessee.
"This will eliminate the need for and existence of any high-risk pool, either state or federal," he said in an e-mail.
The federal high-risk pool actually has lower premiums than the state option, so it will be a good alternative for those not already enrolled in AccessTN, said Tony Garr, president of the Tennessee Health Care Campaign in Nashville.
"There's no enrollment cap for the new federal high-risk pool, so I'm not worried about the (state) one being closed," he said. "It's good benefits at a fairly reasonable charge."
Unfortunately, the federal program does not offer premium assistance for low-income enrollees like AccessTN does, he said.
WHAT IS A HIGH-RISK PLAN?
The federal high-risk health insurance plan offers comprehensive coverage that has no exclusion for people who have pre-existing health conditions and no annual or lifetime benefit limit.
In Tennessee, federal plan members will pay monthly premiums from $286 to $609, depending on age. There is no premium assistance program for Pre-Existing Condition Insurance Plan members. More information about PCIP, including how to apply, can be found online at www.pcip.gov or by calling 1-866-717-5826.
Source: Cover Tennessee, HealthCare.gov