The Los Angeles Times (5/2, Levey) reported, "As many as 20 states likely will not operate new insurance programs for Americans who have been denied health coverage, forcing the federal government to step in and placing a new burden on the Obama administration to implement its health overhaul, according to administration officials." Notably, "Democrats earmarked $5 billion in the recently passed healthcare legislation to create state-based high risk pools as a way to help sick, uninsured Americans between now and 2014." But, "led by the Georgia insurance commissioner...a succession of mostly Republican state officials have been rejecting the idea of creating state pools, voicing concerns that state governments would end up having to pay some of the costs of operating the pools over the next 3 1/2 years."

        According to the AP (5/1), HHS announced on Friday that several "states and the District of Columbia have notified the administration they want to run special high-risk insurance pools. The programs will be in place until 2014 -- when health insurance companies will no longer be allowed to deny coverage to people in poor health." Meanwhile, "15 states said they would not set up their own pools, including several in which Republican governors opposed the overhaul legislation. In those states, the federal government will step in and run the program."

        The Hill (5/2, Pecquet) reported, "The decision whether to operate their own high-risk pool for sick people who can't get insurance has become a highly politicized issue in some states, with a number of Republican governors blasting the $5 billion set aside for the provision as insufficient." The Hill added, "As of mid-day Friday, 21 states and the District of Columbia had decided to run their own pool, while 11 states had opted to let the federal government take over. Of the latter, all have Republican administrations save for Tennessee and Wyoming." In contrast, "all but five of the 21 states that opted to run their own pools are led by Democrats. The exceptions: Connecticut, Rhode Island, South Dakota, Vermont, and California, where Arnold Schwarzenegger on Thursday became the first Republican governor to endorse the health reform law."

        CQ HealthBeat (5/1) noted that as of early Friday afternoon, the following states had indicated that they would operate high-risk pools: "Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Illinois, Kansas, Kentucky, Maine, Maryland, Michigan, Missouri, Montana, New Jersey, North Carolina, Ohio, Oklahoma, Rhode Island, South Dakota, Vermont, and Washington."

        The Wall Street Journal (5/1,) reported that the refusal by several states to participate in the federal high-risk insurance pool shows the "pitfalls" of placing much of the responsibility of implementing healthcare reform on the states. The Journal also noted that the states were chiefly concerned that they would become fiscally responsible for the program once federal funds ran out, and they sought to obtain additional information from the Obama Administration about this concern, to no avail. Indeed, HHS spokeswoman Jenny Backus would only say, "I think we need to get the programs up and running before we start speculating."

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