Well, not all HRPs are created equal, but they might be in the future. The public policy was set up on a state by state basis, by the state legislatures. Much information can be found at the NCOIL website.
The best HRCs were established in statute by the states, participation required by the states, but not funded by them. The funding would come from a very small premium assessment, generally a couple dollars (2 or 3) a month per insured. It would be especially effective if levied on all types of health insurance written in a given state.
It should not be funded by the state because RATs are flakey and would defund it, it is in the best interest of the carriers to have a healthy HRP so they can properly assess risk and keep premium down. It is a near impossible situation once the companies go belly up. The whole insurance industry has been nuked.
Sorry, I mis-posted the last part of your quote.
Many of the companies may well still be writing other types of insurance such as P&C, long term disability etc and may still have cash reserves that can be legally "repurposed".
As a rule, premium is dictated by claims. You can count on total claims, in a given time period, to be between 70 and 80 percent. At least that's the way it used to be in this tortured insurance market. Carriers are limited by law to the lower figure.
If 80% were to be paid out as claims, of the remaining 20%...1/2 of that would likely go to various taxes leaving 10%, then there's lights, rent, loans and wages etc. They probably wind up with about 3% in "profit".
what is the criteria and pricing on these high risk pools.
Well, that's a good question, and it will absolutely vary from state to state. First of all, the HRPs also are meant for the individual policy market, not groups. As I mentioned earlier, carriers writing group coverage figure if you are healthy enough to work, then you are healthy enough to insure.
The HRPs typically contain about 1% of the total of the insured in a given individual market. Those are people with a guaranteed $100,000/yr claim burden, who have applied for, and been denied insurance in the regular pool. IE they have cancer, hemophilia, AIDS etc and never had insurance.
Typically HRP membership tends to stabilize as one of two things can happen, they can eventually qualify for regular insurance if their health improves, or they may succumb to their illness.
People in the regular pool who become that sick ARE NOT kicked out and into the HRP. The companies are stuck with them, but them's the breaks for the carrier, that's what they agreed to do in the initial policy application and subsequent contract.
I believe these pools are assessed frequently so as to have a sufficient amount of reserve for their members, but not too much, so as to protect the premiums of the insured in the regular risk pool.
New Hampshire started off with a dime per month per insured and soon had to cut it back to around 3 cents, but still had too much. I believe they received the $1 million HRP start up money during the Bush administration, states were offered that to improved markets, a majority of states had HRPs before Obama Deathcare.