The board overseeing Iowa’s federal high-risk insurance pool has declined to step in and make changes that would make insurance coverage available to Iowans with HIV, the Des Moines Register reports. The board has refused to seek permission to make a change in its contract with the federal government to accept premium payments on behalf of these Iowans from what are called “third-party payers.” Many other states have sought and received that permission and now allow such payers. As part of the health reform law, Congress created a temporary insurance program to immediately help uninsured Americans. These are people with preexisting health problems who cannot get coverage on the open market. The federal government allocated $35 million to Iowa, which projected it would cover about 1,000 people in its new high-risk pool. In the most recent federal count, only 238 Iowans were enrolled.

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