Federal High-Risk Insurance Pool halts enrollment

The Obama administration is terminating new enrollment and cutting benefits for existing enrollees in the pre-existing Condition Insurance Plan (PCIP).

The federal government will no longer enroll people with pre-existing conditions in its temporary high-risk insurance pool amid signs that the $5 billion program could run out of money sooner than expected. This program was included under the Affordable Care Act (ACA) as a solution for individuals who could not otherwise obtain coverage.

On Friday, the US Department of Health and Human Services alerted plan contractors…that no enrollments will be allowed after March 2, 2013 in the Pre-Existing Condition Insurance Plan, which was created through the federal health-care overhaul.

By suspending enrollment in March will create a 10-month gap in the availability of health insurance coverage for individuals who would have been served by PA Fair Care.

Why is PCIP enrollment being suspended?

PCIP is a temporary program for those locked out of the current insurance marketplace. The program has a limited amount of funding from Congress.

Based on program experience and trends since the start of the program, PCIP enrollees have serious and expensive illnesses with significant and immediate health care needs. More information can be found in the Annual Report on the Implementation and Operation of the PCIP Program
available here Exit Disclaimer Icon.

This suspension will help ensure that funds are available through 2013 to continuously cover people currently enrolled in PCIP.

The Health Insurance Marketplace

Starting next year, the Affordable Care Act guarantees that all Americans – regardless of their health status or pre-existing conditions – will finally have access to quality, affordable coverage. People will be able to apply for affordable health insurance coverage choices in Health Insurance Exchanges when open enrollment begins on October 1. Starting in 2014, the uninsured will be able to obtain health insurance through state and federally run health exchanges.

Paul King and Charlotte Hildebrandt
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