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State Applies for Health Insurance Program

Gov. David A. Paterson on Thursday announced the state’s application to develop a program to help uninsured New Yorkers benefit from the temporary pre-existing condition insurance funding, made available in the federal health care reform statute, the Patient Protection and Affordable Care Act.

The federal statute makes $5 billion available over the next three and a half years, of which New York is expected to receive about $297 million.

The federal government has guaranteed that no financial responsibility for the program will be shifted to the states. The program will provide health insurance coverage to eligible individuals who are uninsured and have pre-existing health conditions, until more comprehensive coverage options become available through a Health Insurance Exchange in 2014.

States have the option of designing their own programs or leaving it up to the Department of Health and Human Services.

New York has requested that Group Health Inc. serve as the designated nonprofit contractor to operate a qualified high-risk pool. By federal rules, only a nonprofit can serve in that role. GHI is an Emblem Health subsidiary and the only nonprofit authorized to operate statewide.

The program is expected to enroll about 15,000 New Yorkers. The federal funds will cover any operational costs and also subsidize premiums, which the state would like to keep below $600 a month. Assuming timely approval, state officials hope to begin accepting applications by Aug. 15, with coverage available by late fall.