Pre-Existing Condition Insurance Plan: More People Sign Up, But Enrollment Still Low

WASHINGTON -- Enrollment in the Affordable Care Act's fledgling program for people with pre-existing conditions inched up to 18,313 in March, the Obama administration recently announced.

The Pre-Existing Condition Insurance Plan, a $5 billion component of the president's health care reform bill, offers low-cost coverage to people who've spent six months or longer excluded from the individual insurance market because of conditions like diabetes, heart disease or cancer. The federal government runs the PCIP in 23 states, while the rest of the states handle it themselves.

Enrollment jumped by nearly 6,000 from the previous update in February -- the biggest increase yet. The Department of Health and Human Services (HHS), which administers the program, lowered premiums earlier this year in an effort to boost enrollment.

For those covered by the PCIP, it can be a godsend. The program was so appealing to one Arizona couple, in fact, that they canceled their insurance policies in January and are spending six months without insurance to qualify for the program come July.

Yet the PCIP's enrollment numbers have been a disappointment for the administration. Though there are millions eligible, officials said it would reach a few hundred thousand at most. Enrollment has fallen far short of even those meager estimates.

During the legislative endgame of health care reform, Democrats touted the new program as one of the greatest "immediate deliverables" of the pending law. (High-risk pools like the PCIP also happen to be the centerpiece of Republicans' alternative vision for health care reform).

The PCIP will be phased out in 2014, when it will be illegal for insurance companies to discriminate against the sick.

HHS buried the new numbers on its website May 6 and did not put out a press release like it did for the previous update in February. A spokeswoman did not respond to inquiries about why HHS chose not to publicize this quarter's enrollment figures.

HuffPost readers: Applying for the PCIP? Tell us about it -- email [e-mail]. Please include your phone number if you're willing to do an interview.

Comments

[MeinNH]

08:13 AM on 05/19/2011

Maybe because the cost is embarrassingly high?

[FaceReality2]

11:04 AM on 05/19/2011

Yep, it sure ain't cheap.

http://www.pciplan.com/applicants/states/TX.asp

[smurrayesq]

06:20 AM on 05/19/2011

I think that this is a failure of marketing. I don't think that most people know about this option.

[SilentSolidarity]

09:52 PM on 05/18/2011

I still don't get why the government has no problem to set up a pre-existing condition plan and extend CHIP and whatnot, but when we ask for a public option...

[FaceReality2]

10:28 PM on 05/18/2011

Because high risk pools serve the interests of the insurance companies--the costs of caring for those with pre-existing conditions are laid off on the taxpayers so they won't affect the bottom line of the insurance companies.

[CharlieVer]

09:13 AM on 05/19/2011

We didn't get the public option for the simple reason that ALL Republicans, in addition to conservative Democrats, opposed it. They almost didn't get ANY healthcare bill passed, because of a handful of Democrats and all Republicans. Joe Lieberman and Blanche Lincoln are two examples of Democrats who refused to sign on to the public option. If we just had a SLIGHTLY higher percentage of Democrats, or more liberal Democrats, public option would now be law.

[lvdragonlady]

09:34 PM on 05/18/2011

Before everyone jumps on a band wagon and starts pointing fingers and whining. THINK!!!
This is NOT open season, so very few (only those newly hired with 90 days under their belt) can change or add to their insurance.
Anyone wonder why the insurance industry only has 1 week a year when people can enroll or change their insurance?

[TXfemmom]

07:15 PM on 05/18/2011

Try to get information on this.  I called and asked both Senators and my Representative on this and not one of them sent me the information requested or returned my call.
 
Additionally, I know there were changes made in terms of being permitted to carry Cobra longer under certain circumstances and I was unable to get any information on that from them either.
 
As for state officials in TX having any information or desiring to share it, yeah right.

[grouseless54]

07:46 PM on 05/18/2011

Also (according to my insurance agent) there is a HIPAA extension for participants in plans that are terminating. Apparently, COBRA is only for (laid off) participants who are no longer employed at businesses with continuing plans. Barring finding out anything from your elected reps, cast about for an insurance agent that is keeping up with health coverage. NV doesn't have much info, either, but I found our business insurance agent had someone in their office that knew quite a bit.

[TXfemmom]

08:04 PM on 05/18/2011

Thanks for the heads up. I have to fan you on that.

[FaceReality2]

10:45 PM on 05/18/2011

Having Cornyn, Hutchinson and Rep. Granger is like not having representation at all. Granger won't answer any of my emails. And all I get from Cornyn and Hutchinson are canned responses. The Republicans don't give a crap about anyone but their corporate donors, and these three jokers are not embarrassed to make that perfectly obvious.

Here are some links:

http://www.pciplan.com/applicants/states/TX.asp

http://www.pciplan.com/forms/pdfs/2011BenefitsSummary.pdf

Did you know Texas has had a high risk pool of its own for years? Of course it was never worth a damn. Check this out:

http://www.txhealthpool.org/PCIP%20Federal%20Pool%20Notice31711.pdf

http://www.txhealthpool.org/RegularPlanRateTables.pdf

[TXfemmom]

01:33 AM on 05/19/2011

Thank you so much.  Fanned

[susie1776]

06:58 PM on 05/18/2011

Why isn;t the government doing ads on this. Maybe so few people are signing up because so few people have a clue it even exists!!!! So much attention was paid to all that "Death Panel" crap last election cycle that I don't think people even heard about this. Instead of burying it, DHHS should be shouting from the rooftops!

[dmortonrei]

04:08 PM on 05/18/2011

Obama wanted a SINGLE PAYER SYSTEM but could not get the votes FROM HIS OWN PARTY to pass his signature legislation.

Taking a page from his Saul ALinsky community organizing days Obama scaled back his plan with the same goal in mind and called it "Insurance reform."

MAKE NO MISTAKE Insurance Reform is DESIGNED TO FAIL. My insurance premiums have nearly doubled in the past year. A friend of mine is on strike because his union needs a $4.65 per hour "give back" (union speak for raise) to fund their "health and welfare" (union speak for insurance premiums). My friend will receive NO PAYRAISE...this $4.65 raise will ALL go to the union to fund their healthcare premiums for the next three years of the contract period.

Those who can no longer afford their HC premiums will be dumped into the Single Payer System OBAMA WANTED IN THE FIRST PLACE.

Eventually we will have TWO tiers of HC.......... a top shelf private HC system for those who can still afford the private HC premiums............ unions have received 50% of the Obamacare waivers so far.......so your local taxes will ensure teachers and others endowed with Obamacare waivers will have that private HC insurance on your dime.

For the rest of us its DMV style HC with the Public Option.

[FaceReality2]

04:16 PM on 05/18/2011

Yeah, let's go back to the system where people with pre-existing conditions can't get insurance. Let them beg for charity. Or die.

[techBob]

05:54 PM on 05/18/2011

Fanned and Faves.
My Daughter needs this program since she has a preexisting condition and since having lost one paralegal job is unable to get another that will provide health-care but are temp positions only being offered her now. The government plan won't accept her until her COBRA is exhausted first and private insurers will not cover her on an individual plan.
Instead of making it easy, as expected the government does everything possible to put enough road blocks in the way so as to discourage anyone from trying to get the coverage that is supposedly available to millions. In the mean time my daughter has to stress over being denied coverage for the rest of her life should this plan fall by the wayside, being forced into a lapse of coverage before 2014 and having to beg the private industry to offer her a policy, any policy ebven though she won't be able to afford the plan.

[thehardertheycome]

10:13 PM on 05/18/2011

You need to do some research. Nothing that you have described sounds close to being true. Your insurance premium went up and would have gone up with or without HCR.

Union negotiations are with the union and their members. Union's are businesses they sole revenue source are contributions. Not many unions to my knowledge are responsible for the health insurance for their members. Usually the company where the members are employed offers insurance and the union is responsible for those people that draw a salary from the union.

Anyway it sounds like you need to do some research because you are severely underinformed.

[jbryson1aa]

09:36 PM on 06/05/2011

Well well, every heard of General Motors? The UAW is now sole proprietor of the membership's health insurance....You do some research, MORON!

[Johnniedog]

03:35 PM on 05/18/2011

This is the same nonsense as the Obama Mortgage fix. These programs are impossible to get into because the expectations are far too high. You have to literally ruin your Credit to get help with your Mortgage and I suspect it is the same with getting on the HealthCare. You have to jump through Hoops and pretty much destroy yourself Financially to qualify.

[FaceReality2]

04:21 PM on 05/18/2011

"These programs are impossible to get into"

Your assumption is wrong. See:

http://www.pciplan.com/

The mortgage program was sabotaged by the banks because they make more money by foreclosure.

[dmortonrei]

03:16 PM on 05/18/2011

Obamacare is so great Pelosi and Democrast are busy handing out exemptions to their union buddies and favored friends.
Last month, April 2011, 204 Obamacare waivers were granted. Of those 208 waivers 38 were "for fancy eateries, hip nightclubs, and decadent hotels in" Nancy Pelosi's San Franciso district.....Hmmmmmmmmm.

Total Obamacare waiver count............ 1372.

According to wheresmywaiver.com 50.26%......... or 686 waivers..........Demcorast have handed out to ................. unions.

No wonder businesses are not hiring when Democrats can pick winners and losers ....... who pays for Obamacare and who gets a waiver.

[CharlieVer]

09:17 AM on 05/19/2011

THEY ARE ONE-YEAR TEMPORARY WAVERS. This is to give the companies time to do the necessary paperwork and due diligence. The wavers are a NON-ISSUE... in a SINGLE YEAR they will EXPIRE and BE GONE!

[FaceReality2]

02:56 PM on 05/18/2011

Don't you just love the baggers and wingnuts who don't give a damn whether their fellow citizens with pre-existing conditions can buy insurance or not? Thinking of them really warms my heart.

[FaceReality2]

02:49 PM on 05/18/2011

An Australian poster on another thread said he paid $150 a month for PRIVATE insurance, which offers better benefits than their government insurance plan. PCIP is lousy by comparison. But then it's far better than what we had before--which was nothing.

[susie1776]

07:03 PM on 05/18/2011

That Aussie poster missed the most important detail as you noted. In Australia EVERYONE has national health coverage. I had a friend who needed several surgeries, including open heart. He received ALL his care at the public hospital and it was excellent. He never got a bill. The Aussie system makes sure everyone is covered but they still have the option of buying "private insurance" if they want to use a "private hospital" But they ALL have coverage. MUCH better than what we have here.

[strohm]

07:40 PM on 05/18/2011

Someone got his bill.

[FaceReality2]

02:46 PM on 05/18/2011

PCIP is better, much better, than nothing, but the premiums and deductibles are still unaffordable for a lot of people.

The sad fact is that medical care in this country is already unaffordable for a huge portion of the population without insurance. The only solution is medical tourism where procedures are a small fraction of what doctors and hospitals charge here, even after the travel costs.

Here is one outfit that utilizes Mexican doctors and hospitals:

http://www.medtogo.com/

[stargazer13]

01:54 PM on 05/18/2011

this is the first I have even heard about it

[Gary Tuma]

11:51 AM on 05/18/2011

When an individual's private insurance premium goes higher than the pre-existing policy's premium one should be allowed to transfer immediately to that plan. Also, the six-month wait is just stupid.

[tosc]

10:37 AM on 05/18/2011

why would I invest in a government conducting a program that is unable to balance their debt? A government that sponsors a program that is likely to be reveresed the minute an incumbent is elected to office is not a viable investment of my hard earned money. Government is not a great investment these days. They are all claiming bankruptcy or at least huge debt loads.

[Viper]

01:41 PM on 05/18/2011

And no company has ever gone bankrupt or needed to be bailed out..like all of Wallstreet or ENRON or Worldcom or Chrysler or TRUMP or 1000etc.

So much for your argument...

Regards