May 10, 2010 — UPDATE: Image from State Net Capitol Journal:

Friday, April 30 was one of the first deadlines established under the federal health care reform legislation.  States were required to decide whether they would work with the federal government to establish a health insurance pool for high risk individuals.

Much of the debate amounted to mere partisan ties.  Of the 29 states that agreed to create a pool, Alaska, California, Connecticut, New Jersey, South Dakota and Vermont have Republican governors.

Participating states didn’t want their residents’ health care left up to the federal government.  A spokesperson from Michigan Governor Jennifer Granholm’s office (D) says, “We know our market. We are connected to our consumers, and we can properly respond to them.”

In Connecticut, Governor M. Jodi Rell’s (R) response to Secretary Sebelius seeks a partnership between the state’s existing pool, which Connecticut formed in 1976, and the requirements of the federal legislation.   According to the Governor, “[Connecticut’s] participation will depend on the state not being forced to pick up any additional financial burdens as a result of the new venture.”

According to the Washington Post, 19 states will not join HHS in creating a state pool:

  • Alabama 
  • Arizona 
  • Delaware*
  • Florida 
  • Georgia 
  • Hawaii 
  • Idaho 
  • Indiana 
  • Louisiana 
  • Minnesota 
  • Mississippi 
  • Nebraska
  • Nevada
  • North Dakota
  • South Carolina
  • Tennessee*
  • Texas
  • Virginia
  • Wyoming*

* the 3 states with Democratic governors

Arizona Governor Jan Brewer (R) explained her decision not to participate by saying, “In light of Arizona’s existing fiscal challenges, I cannot commit the state to a program without confidence that there is funding available to sustain it.”

Expressing similar concerns in a recent press release, Wyoming Governor Dave Freudenthal (D) says, “The state’s involvement would be an unnecessary addition to the process that would result in redundant administrative costs and unnecessary delays in the implementation process.”

Always the rebels, Rhode Island and Utah—both with Republican governors—are undecided.


Additional resources on:

38 states with established high risk pools

State and federal pools 

HHS available funding for the pools by state’s High Risk pool site