Twenty-eight states have advised the U.S. Department of Health and Human Services (HHS) that they will enter into agreements to work with HHS to operate state high-risk pools under provisions of the Patient Protection and Affordable Care Act (PPACA), offering stopgap coverage to uninsured adults with pre-existing conditions.   Fifteen states informed HHS that they will not work with HHS on this.  HHS will have to contract directly with insurers in those 15 states.   Other states were undecided through an April 30 reporting deadline that HHS set on April 2.  States’ legal, financial, and feasibility assessments have been intensive.   California will qualify for the largest state high-risk pool allotment, $761 million out of a $5 billion nationwide appropriation for these insurance pools.   HHS calculated each state’s high-risk pool allotment under a formula similar to the CHIPRA grant allocation formula.   Many states estimate that their allotments will be insufficient.   State and federally contracted high-risk pools are scheduled to be operational by July 1.