State High Risk Pool Funding Extension Act of 2005
By Senator Enzi from Committee on Health, Education, Labor, and Pensions filed written report. Report No. 109-121.
Congressional Research Service
Official summary
Version 01 · Reported to Senate with amendment(s) · Feb 10, 2005
State High Risk Pool Funding Extension Act of 2005 - Reauthorizes funds to provide grants to States to create and operate qualified high risk health insurance pools.
Amends provisions requiring the Secretary to award grants to States with existing qualified high risk pools to cover losses incurred by a State in connection with the operation of such a pool to: (1) remove the limit that provided that such grants would cover up to 50 percent of such losses; and (2) allow such grants to be made to entities that operate such a pool under applicable State law; and (3) change the allocation of such grants to give one-half of the funds to eligible States equally and apportion the other half based on the number of uninsured individual in each State and the number of enrollees in a State's qualified high risk pool. (Currently all funds are allotted based solely on the number of uninsured individuals in a State.)
Requires the Secretary to award grants to States with established qualified high risk pools for the provision of supplemental consumer benefits, which must include one or more of the following benefits: (1) low-income premium subsidies; (2) a reduction in premium trends, actual premiums, or other cost-sharing requirements; (3) an expansion or broadening of the pool of individuals eligible for coverage; (4) less stringent rules or additional waiver authority with respect to coverage of preexisting conditions; (5) increased benefits; or (6) establishment of disease management programs.
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Authorizes appropriations.
Defines "qualified high risk pools" to allow States to provide for enrollment through: (1) a combination of a qualified high risk pool and an acceptable alternative mechanism; (2) health insurance coverage that meets the requirements for a high risk pool, limits rates, is available to all eligible individuals, and does not exceed the rate limit allowed for high risk pools; or (3) health insurance coverage that provides first dollar coverage, limits on cost-sharing, and comprehensive medical, hospital, and surgical coverage if the rate limits do not exceed 125 percent of the rate limit otherwise allowable for qualified high risk pools.
Source last updated: Apr 21, 2025. Consult Congress.gov for the current record.
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