FRANKFORT — Still in its infancy, a state-subsidized insurance program for those with high-cost medical conditions has reaped savings for the few signed up, Insurance Commissioner Janie Miller said Wednesday.

        Ms. Miller told the House Banking and Insurance Committee that 109 people applied as of Jan. 31 for coverage under the program, Kentucky Access. Forty-nine are enrolled, and the other applications are under review.

        The state began taking applications in December for a “high risk pool” to cover people in poor health who could not afford private coverage or whom private insurers had refused.

        The average monthly premium for Kentucky Access enrollees is $497.90, about $100 to $200 less than they would have paid for coverage directly from the private marketplace, Ms. Miller said.

        “Kentucky Access represents a very good value, a good alternative,” said Ms. Miller, who recently took over as insurance commissioner.

        Ms. Miller's update failed to convert at least one critic of Kentucky Access.

        Rich Seckel, a member of Kentuckians for Health Care Reform, said afterward that Kentucky Access was a retreat in state insurance policy, and that those most in need of coverage would struggle to obtain it.

        “It doesn't look like low-income people would be able to take advantage of the plan,” said Mr. Seckel, who didn't testify.

        In the private marketplace, rates for individual policies are headed in opposite directions, depending on a person's health, Ms. Miller said.

        Among the healthiest Kentuckians, rates for individual health insurance could drop by 5 percent to 10 percent, the first decreases in several years, Ms. Miller said.

        For those who are un healthy, and have made insurance claims to pay medical expenses, premiums for individual policies could rise as much as 20 percent, she said.

        In the small-group market, a majority of Kentucky employers offering health coverage to workers also face higher premiums, she said.

        The higher health insurance rates are part of a national trend as health-care costs continue to rise, Ms. Miller said.

        One positive trend is that Kentuckians have more options in choosing health coverage, Ms. Miller said. Another insurer is expected to enter the market soon, joining a handful of companies selling policies, she said.

        “We don't have total stability in the marketplace, but we are certainly moving in the right direction,” Ms. Miller told the committee.

        Ms. Miller said rates could improve as more insurers return to Kentucky.

        The insurance market has been in disarray in Kentucky since the state tried to force insurance companies to cover everyone and cap rates in a failed overhaul of health insurance in 1994. All but two companies fled the state and refused to provide coverage for individuals.

        Much of the committee's focus Wednesday was on Kentucky Access, which is so new that it hasn't yet paid its first claim.

        Rep. Mitchel “Mike” Denham, D-Maysville, said he was concerned many people who could benefit from Kentucky Access don't know it exists.

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