North Carolina recently became the 35th state to offer a high-risk insurance plan. According to its website, Inclusive Health "provides affordable, individual health insurance coverage for North Carolinians who do not have access to an employer health plan and face higher premiums due to a pre-existing medical condition. It will also offer coverage to individuals who are federally defined HIPAA eligibles or qualify due to loss of employment due to the effects of international trade under the Health Coverage Tax Credit."
Although the program established by the state government, the pool is a public/private mix. Inclusive Health is a non-profit agency overseen by a board appointed by the Governor's Office and the NC State Legislature. The board includes insurance company, medical, hospital, and consumer representatives. The agency has a $30 million annual budget funded by premiums, fees paid to the State by insurance companies, and money from the tobacco settlement fund.
Today the program got front-page coverage in The News & Observer, published in Raleigh. The article reported that an estimated 1.4 million North Carolinians don't have health insurance, but so far, only 2,000 have enrolled in Inclusive Health, which is half the number that was expected. The article also notes that the program has a limited marketing budget and is not widely known.
The article included a couple of case studies:
- A diabetic who lost his group coverage was unable to afford an individual policy with BCBS, which has 86% of the health insurance policies in the state (including mine). BCBS quoted him a monthly premium of over $1600. He now pays $550 a month for Inclusive Health.
- In a family with seven children and a stay-at-home mom, the husband got laid off, then his COBRA ran out. One of their children had previously contracted a rare form of cancer. The family could get private insurance for $650 a month, but it excluded the child who had had cancer. BCBS quoted her a premium of $975 a month, but also referred her to Inclusive Health. They now pay $250 a month to insure their child, whose cancer is in remission.
The largest group of participants in the pool are people who make $40,000 to $60,000 a year.