Risk pools for the medically uninsurable
aid those turned down for health insurance

Health insurance risk pools are state programs for the medically uninsurable

IMPORTANT UPDATE: On July 1, states began accepting applications for enrollment in high-risk insurance pools established through the recently passed Patient Protection and Affordable Care Act.

The Pre-Existing Condition Insurance Plan (PCIP) was created to make health coverage available to Americans who have been denied coverage due to pre-existing conditions.

The pools, backed by $5 billion in federal money, will offer subsidized premiums to people who have been uninsured for at least six months and have yet-to-be-defined medical problems. Coverage will be available through the risk pools until 2014, when consumers will have access to affordable health coverage through insurance exchanges also established by the landmark health reform legislation.

Risk pools will be available in every state, though states will choose whether to run the risk pools themselves using resources from the Affordable Care Act or rely on the federal government to provide coverage. Twenty-two states have chosen to have the federal government administer their high risk pool, and began taking applications on July 1. The remaining 28 states and the District of Columbia will operate their own programs and begin taking applications within the next few months.

Thirty-five states already operated high-risk insurance pools, providing health coverage to about 200,000 Americans. Unfortunately, under the health reform legislation, those individuals will not be able to switch to the federally established risk pools unless they go without health coverage for at least six months.

Why were state high-risk insurance pools created?

A majority of Americans – nearly 60 percent according to the U.S. Census Bureau – get employer-sponsored health coverage under group health insurance. Another 27 percent of the population is covered by government-sponsored health care – through Medicare, Medicaid, children's health care programs (CHIP), military health care, and various state programs for low-income populations.

Those left over are the self-employed or those working for very small companies that don't provide health insurance benefits. If that describes you, you must directly purchase coverage directly through private health insurance companies.

If you and your family have always been healthy, you should be able to do a quick online search for health insurance quotes and then choose from the variety of plans and benefits available in your state. However, if you've already been treated for a medical condition, or have a history of certain high-risk factors, you may be unable to find a health insurance company that will offer you comprehensive health insurance at any price.

According to a 2007 report by United Health Foundation, 15.9 percent of all Americans were uninsured. State-sponsored risk pools are aimed at helping a small slice of those Americans: those who can afford to buy health insurance, but who are denied affordable health insurance coverage by insurance carriers because of a pre-existing medical condition.

Risk pools – started in Minnesota back in 1976 – created pools from individuals denied coverage by private insurance companies, then provide state-sponsored health insurance plans these individuals can buy into – albeit at a higher cost than if they were able to qualify for a private plan. Currently, 34 states offer some form of risk pool, and these risk pools cover about 183,000 people.

At their core, risk pools are state-created, nonprofit associations that – in most states – doe not require tax dollars for their operational purposes. A risk pool can be a temporary stopping point for individuals who are denied health coverage – or for individuals who need to fill a gap in insurance coverage.

Some risk pools have done an excellent job of providing alternatives for their citizens, while others have done very little because their health insurance plans are not designed well, or are not funded properly by their states – or they were simply unaffordable. The risk pools created by the Affordable Care Act are intended to remedy these shortcomings.

State risk pools and where to contact them


Thumbs up on offering a risk pool.; Alabama Health Insurance Plan
Toll-free 1-800-513-1384 or (334) 353-8924

Thumbs up on offering a risk pool.; Alaska Comprehensive Health Insurance Association
Toll-free 1-888-290-0616

Thumbs up on offering a risk pool.; Arkansas Comprehensive Health Insurance Plan
Toll-free 1-800-285-6477

Thumbs up on offering a risk pool.; California Major Risk Medical Insurance Program
Toll-free 1-800-289-6574 or (916) 324-4695

Thumbs up on offering a risk pool.; CoverColorado
(303) 863-1960 or toll-free 1-866-787-9129 (M-F 8am–5pm)

Thumbs up on offering a risk pool.; Connecticut Health Reinsurance Association
Toll-free 1-800-842-0004 (M-F 9am-4pm EST)

Thumbs up on offering a risk pool.; Florida Comprehensive Health Association (closed to new enrollees since 1991)
(850) 309-1200

Thumbs up on offering a risk pool.; Idaho Individual High Risk Reinsurance Pool
(link is to a PDF on program)
Toll-free 1-800-721-3272 (In-state only)

Thumbs up on offering a risk pool.; Illinois Comprehensive Health Insurance Plan
Toll-free 1-866-851-2751 (in-state only) or (217) 782-6333

Thumbs up on offering a risk pool.; Indiana Comprehensive Health Association (click "guest" for access, then choose "ICHIA")
Toll-free 1-800-552-7921 or (317) 614-2000

Thumbs up on offering a risk pool.; Health Insurance Plan of Iowa
Toll-free 1-877-793-6880 (M-F 8am-5pm CST)

Thumbs up on offering a risk pool.; Kansas Health Insurance Association
Toll-free 1-800-362-9290 (M-F 8am-5pm)

Thumbs up on offering a risk pool.; Kentucky Access
Toll-free 1-866-405-6145

Thumbs up on offering a risk pool.; Louisiana Health Plan
Toll-free 1-800-736-0947 or (504) 926-6245

Thumbs up on offering a risk pool.; Maryland Health Insurance Plan
Toll-free 1-888-444-9016 (M-F 8am-5pm)

Thumbs up on offering a risk pool.; Minnesota Comprehensive Health Association
Toll-free 1-866-894-8053

Thumbs up on offering a risk pool.; Mississippi Comprehensive Health Insurance Risk Pool
Toll-free 1-888-820-9400

Thumbs up on offering a risk pool.; Montana Comprehensive Health Association
Toll-free 1-800-447-7828

Thumbs up on offering a risk pool.; Nebraska Comprehensive Health Insurance Pool
(402) 343-3574 or toll-free 1-877-348-4304 (M-F 8am-4:30pm)

Thumbs up on offering a risk pool.; New Hampshire Health Plan
Toll-free 1-877-888-6447

Thumbs up on offering a risk pool.; New Mexico Medical Insurance Pool
(505) 622-4711

Thumbs up on offering a risk pool.; North Carolina Health Insurance Risk Pool (NCHIRP)
Toll-free 1-866-665-2117

Thumbs up on offering a risk pool.; Comprehensive Health Association of North Dakota (North Dakota health insurance risk pool)
Toll-free 1-800-737-0016 or (701) 277-2271

Thumbs up on offering a risk pool.; Oklahoma Health Insurance High Risk Pool
Toll-free 1-800-255-6065 or (913) 362-0040

Thumbs up on offering a risk pool.; Oregon Medical Insurance Pool
Toll-free 1-800-848-7280 or (503) 225-6620 (M-F 8am-5pm)

Thumbs up on offering a risk pool.; South Carolina Health Insurance Pool
Toll-free Phone 1-800-868-2500, ext. 42757, or 1-803-788-0500, ext. 42757 

Thumbs up on offering a risk pool.; South Dakota Risk Pool
605-773-3148 (ask for a Risk Pool representative)

Thumbs up on offering a risk pool.; Tennessee's Tenncare Program
1-888-486-9355

Thumbs up on offering a risk pool.; Texas Health Insurance Risk Pool
1-888-398-3927

Thumbs up on offering a risk pool.; Utah Comprehensive Health Insurance Pool
Toll-free 1-800-705-9173 or (801) 442-6660

Thumbs up on offering a risk pool.; Washington State Health Insurance Pool
Toll-free 1-800-877-5187

Thumbs up on offering a risk pool.; West Virginia Health Insurance Plan
1-866-445-8491

Thumbs up on offering a risk pool.; Wisconsin Health Insurance Risk Sharing Plan
Toll-free 1-800-828-4777

Thumbs up on offering a risk pool.; Wyoming Health Insurance Pool (scroll down)
(307) 634-1393

Health Insurance 101 Articles

Individual Health Insurance – how to get quotes and coverage if you are not covered at work

Health Insurance Companies – compare companies to find the best health insurance fit.

Self-employed Health Insurance – navigating the tricky waters of individual health care policies

Short Term Health Insurance – temporary medical coverage to fill gaps when between insurance companies

Student Health Insurance – medical coverage for your college student

COBRA Health Insurance – the strengths and weaknesses of the federal safety net

Group Health Insurance – appeal of employer-sponsored plans is obvious

Medicare Supplements – range of benefits to bridge Medicare coverage gaps

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