Politics Split States On High-Risk Health Coverage

By Christopher Weaver

Published May 3, 2010 at 3:23 PM EDT

Among the first deadlines for states under the new federal health law came and went Friday, and the results show plenty of political baggage is still in tow.

Florida Gov. Charlie Crist, a Republican for now, felt for middle ground on the federal government's offer to help his state to participate in a project that will help insure sick people with preexisting conditions. Even as he demurred from the invitation, he promised the Obama administration, "We stand ready to assist you."

Florida Gov. Charlie Crist wants Washington to run the state's high-risk pool.

Crist, of course, is in the middle-ground business right now. Last week, he announced he would leave the Republican Party to run for the U.S. Senate as an independent, news that Politico says underscores "the needle-threading political exercise ahead for him." To win the Senate race, Crist will need to attract droves of Democrats without alienating too many Republicans who may prefer his more conservative primary challenger, Marco Rubio.

At issue is a $5 billion in federal funds that will help set up "high-risk" insurance pools for people who are unable to get coverage on their own because of preexisting conditions. The health law gives states a choice: Take your share of the money and set up your own program, or the federal government will do it. Friday was the deadline for states to let the administration know the verdict. As of late Friday, 27 states and the District of Columbia said they'd do it themselves. Seventeen, including Florida, will let the feds run their pools. HHS hadn't released the decisions of the rest.

For some other Republican governors, that decision appeared easier than Crist's. Mark Sanford, South Carolina's beleaguered chief executive, said, "The idea of adding another unfunded mandate is dangerous." Texas Gov. Rick Perry, said, "As we've seen in federal education and stimulus programs, the administration is again asking states to commit to a program without knowing the rules of engagement."

States whose governors rejected the high-risk pool program will still reap some benefits. The program will simply be administered by the federal government instead of the states. For instance, Texas is expected to get $493 million in the deal, despite Perry's objections. Perry and other governors worry that if that funding runs out before the program expires on Jan. 1 2014, their states will be on the hook for financing it.

While the states that object are mostly led by Republicans -- at least eleven of the states that rejected the partnership are also suing the government over the health overhaul.

And, it's only fair to point out that a handful of Democratic governors -- including Jack Markell of Delaware, Phil Bredesen of Tennessee and Dave Freudenthal of Wyoming -- have also asked Washington to run the new pools itself.

Weaver is a reporter for , a nonprofit news service.