In 2007, on average, the premium loss ratio was 161 percent in state high risk pools (NASCHIP, 2008: 39).
Under HIPAA requirements, these plans had to meet key provisions of the NAIC model legislation to qualify (NASCHIP, 2007: 8).
By 2008, thirty-four state pools were designated as alternative mechanisms (NASCHIP, 2008: 45).
To date, six states have pursued this approach (NASCHIP, 2008: 33).
Twenty-three states have designated their high-risk pools as eligible for HCTC participation (NASCHIP, 2008: 41).
Some states have capped or closed enrollment due to fiscal stress, including Florida and California (NASCHIP, 2008: 14, 68).
In addition, NASCHIP and its allies have largely embraced and welcomed consideration of how premium subsidies, more integrated models of health care delivery and case management, and broader funding mechanisms that tap into general revenue pools to share program costs across society and economy can be adopted (Gruber, 2007; America's Health Insurance Plans, 2004).