Federal and Ohio officials couldn't agree on spending for a state-run stopgap health-insurance plan that covers Ohioans who can't get coverage elsewhere, so the U.S. government will take it over, state officials said yesterday.
Federal and Ohio officials couldn’t agree on spending for a state-run stopgap health-insurance plan that covers Ohioans who can’t get coverage elsewhere, so the U.S. government will take it over, state officials said yesterday.
The program, part of President Barack Obama’s health-care law, is meant to be a temporary patch until 2014, when the federal law will require insurers to accept all applicants, regardless of medical history. The law capped spending on the program nationally at $5 billion, and the money is running out because the beneficiaries turned out to be costlier to care.
Last month, the Obama administration gave proposed terms for the program’s remaining months to the state-based plans. If no agreement could be reached, the federal government would take over that state’s program for the rest of this year.
The administrator of Ohio’s program requested more funding, but it was denied, Lt. Gov. Mary Taylor wrote in a letter yesterday to U.S. Department of Health and Human Services Secretary Kathleen Sebelius.
Taylor, the state’s most vocal critic of the federal health-care law, also wrote that she was concerned about the impact that the shift to a federally run program could have on residents.
“Changes to benefits, treatment plans, deductibles, access to provider networks and a potential lapse in coverage later in 2013 could harm consumers relying on the high-risk pool for their health care needs,” wrote Taylor, who is also the state’s insurance director.
The federal proposal was $12 million less than what was needed to ensure that those with serious medical problems could maintain their benefits, Ohio estimated.
Messages seeking comment were left yesterday with HHS.
The program, the Pre-Existing Condition Insurance Plan, targets patients who applied for insurance but were turned down because of pre-existing conditions such as cancer or heart disease.
States and local nonprofit organizations in 27 states administer the program, while the federal government runs the remaining plans. About 100,000 people participate nationwide.
Medical Mutual of Ohio, a nonprofit insurance company, administers the state’s program. It covers more than 3,500 people.
A spokesman for Medical Mutual in Cleveland said the company’s contract for administering the program will end on June 30 and that it will work with the federal government for a smooth transition.