Published June, 2010

Health Care Reform: Temporary Federal High Risk Insurance Pool Program, Julie Cross/HIV Health Care Access Working Group (2010)

This fact sheet provides a preview of what the 2010 U.S. health care reform legislation will do to increase medical and prescription drug coverage for people living with HIV. Comprehensive and uninterrupted access to Medicaid and health care benefits are essential for individuals living with HIV who are often labelled "uninsurable" and denied access to life-preserving medications. While the new health care reform law promises to extend access to health insurance benefits for many individuals, a majority of new insurance opportunities will not likely materialize until 2014. To address the needs of the uninsured in the interim, the US Department of Health and Human Services (HHS) developed a temporary "high risk pool" insurance program that offers temporary help to those who do not have access to insurance as a result of a pre-existing condition. This report provides a summary of the program's structure and goals, including a list of who is eligible for coverage, which pre-existing conditions are covered, and the projected costs of insurance under the high risk pool program. Also included are the high-risk pool insurance program's timeline, eligibility requirements, and a list of resources for individuals seeking further information. Lastly, there is an outline of the options for states as they implement the program, including building on their own programs or taking no action and accepting direct federal coverage, and what particular options individuals states that have decided to follow.

The HIV Health Care Access Working Group is a coalition of 84 national and community-based AIDS service organizations representing HIV medical providers, advocates and people living with HIV/AIDS and providing critical HIV-related health care and support services.