Evaluation of State Risk Pools: The Current and Potential Experience

How have state risk pools for the medically uninsurable addressed the insurance needs of these individuals to date, and how are they likely to address their needs in the future? This study, conducted by the University of North Carolina, Chapel Hill, assessed the enrollment and utilization experience of state risk pools that have been in operation for at least three years to help determine the extent to which risk pools have increased access to health insurance. The project used program records and claims and enrollment data from each pool to examine: 1) the characteristics and experience of each pool; 2) each pool's disenrollment experience and the previous coverage status of enrollees; 3) the utilization patterns and expenditures over time, including those related to the enrollees, "uninsurable" conditions; and 4) the current and potential effects of managed care techniques (e.g., high-cost management) used by the pools.