news-record.com

The N.C. Health Insurance Risk Pool launched with little fanfare Jan. 1 will serve only a few of the estimated 1.4 million residents with no health insurance, but it's still a commendable beginning.

Making it easier for people with high-risk pre-existing medical conditions to get subsidized coverage rather than paying exorbitant premiums to private insurers is the laudable goal.

Not everyone will qualify, and it won't come cheap. Premiums, for example, will be set at 150-200 percent of a healthy person's privately purchased health insurance. Yet that could amount to a substantial savings even though monthly out-of-pocket costs might be hundreds of dollars.

Although as many as 180,000 state residents are thought to be eligible, the program has gotten off to a surprisingly slow start. Since enrollment opened in October, only 500 applications have been received and several hundred approved -- far short of the 4,000 projected for 2009.

To qualify, applicants can't have access to employer-funded policies and don't qualify for Medicare or Medicaid. Those eligible do include the unemployed covered by the federal COBRA plan as well as people who have lost jobs because of international trade and meet requirements for a federal health-coverage tax credit.

The risk pool's helpful Web site, inclusivehealth.org, answers questions, provides an application, and shows how to compute costs. Anyone who might even remotely qualify for coverage should take time to check it out.

Michael Keough, the program's executive director, sees it as "the insurer of last resort for people with pre-existing conditions who need affordable health insurance coverage." As the economy contracts and layoffs loom, those numbers could rise dramatically this year. For some, it may be a stopgap move between jobs. Others may be in for the long haul.

However, a major drawback is that low-wage earners may not be able to afford coverage at any price. Unless they qualify for Medicaid, health care may be out of their reach. For now, the thorny issue of more far-reaching federal and state health coverage remains unresolved.

Even so, following in the path of the 34 other states that already operate insurance risk pools is a step forward.

North Carolina's subsidized plan appears to be on solid financial ground with funding from a tax on health insurance premiums, a $5 million grant from the Health and Wellness Trust Fund and State Health Plan money.

In the long run, making medical care more readily available to the chronically ill saves money because costs rise as they get sicker. Including more people should be the next assignment.