To help lower premiums in the individual health insurance market, many states have created high-risk pools that provide coverage to people with high medical expenses. Legislation has recently been introduced to expand a new federal grant program that provides $80 million in matching funds to help finance state high-risk insurance pools. For this project, the investigators will conduct a six-month study of how states use these federal matching grant funds. After first assessing the adequacy, affordability, and accessibility of high-risk pool coverage relative to a benchmark health plan, they will next determine if the matching funds were used to make improvements in these three areas. Through interviews and examination of high-risk pool reports, the project team will also ascertain if funding has been used to offset risk pool losses or reduce insurers' or hospitals' contributions to the pool. This information will assist policymakers as they determine what role, if any, high-risk pools can or should play in health care reform strategies. http://www.georgetown.edu