High-risk Health Insurance | St. Louis Public Radio

High-risk Health Insurance

Regina Hartfield speaks with her daughters Khia, 14, and Destinee, 12 , as they eat dinner. Hartfield's children were dropped from Missouri's Medicaid program.
File photo I Carolina Hidalgo | St. Louis Public Radio

On Aug. 9, Holly Uchtman and her 7-year-old son Zyler headed to their weekly appointment at Mercy Hospital in Springfield. Zyler has Duchenne muscular dystrophy, a rare, terminal disease that causes muscles to weaken and eventually stop working. For two years, Zyler had been receiving eteplirsen, gene therapy that helped his muscles keep their shape.

But that day, there was a surprise on the other side of their journey. The state had removed Zyler from Medicaid, which pays for his nearly $40,000-a-week treatment. They were turned away, and he missed his appointment.

This article first appeared in the St. Louis Beacon, Aug. 10, 2011 - When Missouri set up a new high-risk health-insurance pool last year, officials projected that the program would serve about 3,000 people. In fact, fewer than 600 have signed up, with many others saying they cannot afford the premiums.

That's part of the reason state insurance officials have announced rate reductions averaging 23 percent for new and existing participants. The rate reductions are funded with $81 million in federal funds and premiums by policyholders.

This article first appeared in the St. Louis Beacon, May 4, 2010 - Missouri will get $81 million in federal money to set up an affordable health-insurance pool for residents with pre-existing conditions and without coverage for at least six months. The new program is part of a $5 billion nationwide high-risk pool created by the health-reform law, the Patient Protection and Affordable Care Act.

Missouri is unsure how many people will be insured through the new pool, says Travis Ford, spokesman for the Missouri Insurance Department.

This article first appeared in the St. Louis Beacon, April 14, 2010 - Missouri is rushing to meet one of the first major tests of the new federal health-reform law by setting up a high-risk insurance pool for people denied affordable health coverage because of pre-existing conditions, such as cancer, diabetes and heart ailments.

This provision is supposed to be in place by July 1, but Missouri health-insurance officials say the federal government has yet to spell out all the rules for setting up the pools.