Utah lawmakers and healthcare officials are talking about bringing back high risk pools to Utah’s health insurance market. They met at the state capitol Wednesday for an update on the state’s healthcare system.
At the Health and Human Services Committee meeting, one of the featured speakers was Greg Poulsen, the Senior Vice President at Intermountain Healthcare. He said providers like his aren’t making a profit under the Affordable Care Act.
"We recommend recreating the concept of a high-risk pool around those with very very high, but predictable expenses," Poulsen said.
High risk pools existed in Utah before the ACA. They put all the most medically expensive people in one insurance group. That lowers rates for everyone else, but they were controversial. Some people said they quickly reached the limit of their health coverage.
Poulsen says this time, funding could come from the federal government, rather than the state, to improve the care for people in a high risk pool.
"Not only are they not second-class citizens, they’re in fact elevated, essentially, to the head of the class because an insurer who has responsibility for them knows that by keeping them as healthy as possible they can save huge amounts of money," Poulsen said.
Representative Edward Redd practices internal medicine and psychiatry. He was concerned about who would end up in a high risk pool.
"How do you define the high risk pool? What does that high risk pool look like and what happens when people transition out of one group? Who makes that decision?" Redd asked.
But Redd agreed the current health insurance marketplace is vulnerable and in need of change.
"If you’re going to save that market from disintegration, which is what it’s doing right now, you’re going to have to do something," Redd said.
If high risk pools are reintroduced in Utah, officials at the Utah Insurance Department said they would be created through legislative action in the 2018 session.