High-risk pools are State programs that were recently brought under Federal review by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). For a subsidized, yet above-standard premium, they provide coverage to individuals lacking access to private health insurance, typically due to pre-existing conditions. Reducing high-risk pool premiums in all States to the level prevailing in the most generous States (at an annual cost of about $105 million) could lead to a modest but significant increase in enrollment, relative to the uninsurable population. In addition, non-premium changes, for example to benefits and marketing, could also have substantial effects on enrollment.