Guaranteed Issue Individual Health Insurance - A State-by-State Guide
In my previous post, I wrote about the 1996 HIPAA legislation and its requirement that states offer guaranteed-issue health insurance to all of its HIPAA-eligible residents. I also mentioned that 40 states go far and above what HIPAA mandates. These states offer forms of guaranteed issue individual health insurance (e.g. risk pools) to their medically uninsurable residents, regardless of the HIPAA requirements.
Health insurance sold on a guaranteed issue basis cannot reject applicants based on health or risk status. In a few states (e.g. New Jersey) all individual market insurers must guarantee issue all individual plans. In others states guaranteed issue requirements are much less restrictive.
If you have questions, please comment.
| State |
> HIPAA? |
Risk Pool |
Notes |
| Alabama |
No |
AHIP |
|
| Alaska |
Yes |
ACHIA |
|
| Arizona |
No |
N/A |
|
| Arkansas |
Yes |
CHIP |
|
| California |
Yes |
MRMIP |
|
| Colorado |
Yes |
CoverColorado |
|
| Connecticut |
Yes |
HRACT |
|
| Delaware |
No |
N/A |
|
| D.C. |
No |
N/A |
|
| Florida |
Yes |
N/A |
Eligible individuals, who are uninsured for 6 months, can buy a guaranteed issue limited benefit policy through the Cover Florida Health Care Program |
| Georgia |
No |
N/A |
|
| Hawaii |
No |
N/A |
|
| Idaho |
Yes |
N/A |
Individual market insurers must guarantee issue standardized policies to the medically uninsurable. These policies are called High Risk Pool Policies. |
| Illinois |
Yes |
ICHIP |
|
| Indiana |
Yes |
ICHIA |
|
| Iowa |
Yes |
HIPIOWA |
|
| Kansas |
Yes |
KHIA |
|
| Kentucky |
Yes |
Kentucky Access |
|
| Louisiana |
Yes |
LHP |
|
| Maine |
Yes |
N/A |
All Insurers must Guaranteed Issue all products |
| Maryland |
Yes |
MHIP |
|
| Massachusetts |
Yes |
N/A |
All Insurers must Guaranteed Issue all products |
| Michigan |
Yes |
N/A |
BCBS of Michigan is Insurer of last resort |
| Minnesota |
Yes |
MCHA |
|
| Mississippi |
Yes |
MCHIRPA |
|
| Missouri |
Yes |
MHIP |
|
| Montana |
Yes |
MCHA |
|
| Nebraska |
Yes |
NECHIP |
|
| Nevada |
No |
N/A |
|
| New Hampshire |
Yes |
NHHP |
|
| New Jersey |
Yes |
N/A |
All Insurers must Guaranteed Issue all products |
| New Mexico |
Yes |
NMMIP |
|
| New York |
Yes |
N/A |
All Insurers must Guaranteed Issue all products |
| North Carolina |
Yes |
Inclusive Health |
|
| North Dakota |
Yes |
CHAND |
|
| Ohio |
Yes |
N/A |
Individual Market Insurers must guarantee issue standardized policies on a periodic basis. |
| Oklahoma |
Yes |
OKHRP |
|
| Oregon |
Yes |
OMIP |
Individual Market Insurers must guaranteed issue portability policies to individuals with 6 months creditable coverage |
| Pennsylvania |
No |
N/A |
|
| Rhode Island |
Yes |
N/A |
Individual market insurers must guarantee issue all products with 12 months of creditable coverage, provided that the applicant is not eligible for alternative group coverage, Medicare or any other state insurance plan |
| South Carolina |
Yes |
SCHIP |
|
| South Dakota |
Yes |
SDRP |
|
| Tennessee |
Yes |
AccessTN |
|
| Texas |
Yes |
TXHIP |
|
| Utah |
Yes |
HIPUtah |
|
| Vermont |
Yes |
N/A |
All Insurers must Guaranteed Issue all products |
| Virginia |
No |
N/A |
|
| Washington |
Yes |
WSHIP |
|
| West Virginia |
Yes |
AccessWV |
|
| Wisconsin |
Yes |
HIRSP |
|
| Wyoming |
Yes |
WHIP |
|
SRC: State Health Facts Website
Note: This should not be taken as legal or tax advice.
