The Washington Post (5/4, Hilzenrath) reports, "Eighteen states have said they will not administer a stopgap program to provide insurance coverage to people whose preexisting conditions have left them uninsured, forcing the federal government to do the work." These "states' decisions increase the challenge the government faces as it sets out to translate the far-reaching health-care legislation into action, and they hint at the complexities to come." To date, "29 states plus the District of Columbia had said they would do so...18 said they would leave the job to HHS," and the "others were undecided." Notably, "enrollment dates will vary" for each state, and they depend on various factors. Jay Angoff, director of the HHS Office of Consumer Information and Insurance Oversight, said, "Some states will be able to" adopt the new regulations "more quickly than others."

        CQ HealthBeat (5/4, Norman, subscription required) explains that "Rhode Island and Utah have requested applications and will make decisions later, while there's no official word yet from Florida or Arizona, HHS officials said." But, "the Miami Herald reported that Florida Gov. Charlie Crist sent a letter to HHS Secretary Kathleen Sebelius late April 30 saying his state will not set up its own program." So far, the following states have opted out: "Alabama, Delaware, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia, and Wyoming." Therefore, "HHS [will] run programs in those states."

        Politico (5/4, Haberkorn) notes, "The first major decision for the states under the new health care law -- on establishing high risk insurance pools -- has come and gone with the decisions so far made mostly along party lines." In fact, only seven states with Republican governors agreed to participate in the federal high-risk pool. Politico says that "the results show just how divisive the health reform plan still is." Nevertheless, HHS spokeswoman Jenny Backus "said the department was pleased with the results from the states." Backus stated, "Whether states create these pools or the federal government creates them for states, the pools will be paid for by 100 percent federal dollars and most importantly -- uninsured people around the country will soon have access to another affordable coverage option."

        Similarly, NPR's (5/4, Weaver) "Shots" blog reports, "Among the first deadlines for states under the new federal health law came and went Friday, and the results show plenty of political baggage is still in tow." Case in point, "Florida Gov. Charlie Crist, a Republican for now, felt for middle ground on the federal government's offer to help his state to participate in a project that will help insure sick people with preexisting conditions. Even as he demurred from the invitation, he promised the Obama administration, 'We stand ready to assist you.'"

        West Virginia To Participate In Federal High-Risk Pool. The AP (5/4, Messina) reports, "Up to 1,200 West Virginians could finally get coverage through the first program to emerge from the recent federal health care legislation, state officials said Monday. Gov. Joe Manchin has told federal officials that the state wants to contract with them to create a temporary high-risk pool as allowed by the new law." Notably, the "pool would cover West Virginians with pre-existing conditions who have been uninsured for at least six months. Those eligible would have been unable to buy coverage even from the state's existing high-risk pool, known as AccessWV."

        Idaho Declines Participation In Federal High-Risk Pool. The Idaho Reporter (5/4, Iverson-Long) reports, "Gov. Butch Otter informed the US Health and Human Services Department (HHS) that Idaho will opt out of a plan to expand the state's pool using federal money to cover people who health insurance companies rejected for coverage due to pre-existing conditions like diabetes and cancer." The state's "high-risk pool, which is run by the Department of Insurance, covers approximately 1,500 people."

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