Feds cut price for pre-existing condition plan

Print Friendly and PDF By: Andy Miller Published: May 31, 2011

So far, the health reform program to cover people with pre-existing medical conditions has drawn disappointingly few people.

Only 18,000 Americans have enrolled in the Pre-existing Condition Insurance Plan (PCIP) since it debuted last year.

Georgia’s number? Just 515, as of March 31. That’s despite the fact that an estimated 20 percent of the state’s residents, or about 1.9 million people, lacked health insurance in 2009, the latest year for which Census Bureau statistics are available.

To boost enrollment in the pre-existing condition program, the U.S. Department of Health and Human Services announced Tuesday that it will reduce the monthly premiums that consumers pay for coverage in Georgia and 16 other states.

Monthly premiums for Georgians will drop by 15.5 percent starting July 1. That means a 50-year-old Georgia resident can get health coverage for as low as $338 per month, HHS said.

In other states, the premiums will be decreased even further. In Florida, Alabama and Kentucky, they will be cut by 40 percent.

PCIP is intended to help uninsured people with pre-existing conditions, such as diabetes and cancer, get coverage before 2014. At that point, if the health reform law survives court challenges, health insurers will no longer be allowed to deny coverage to people with such conditions.

Before launching PCIP, federal officials had estimated that hundreds of thousands of Americans would sign up. But cost has been a barrier to enrollment, they now admit. The premiums are being adjusted to make the price comparable to what healthy individuals pay for individual insurance, officials said.

The premium reductions apply to 17 of the 23 states that have their pre-existing insurance program run by the federal government. Georgia last year opted to let HHS operate the plan in the state.

HHS also is easing the rules to gain coverage. An applicant now can provide a letter from a physician, physician assistant or nurse practitioner, dated within the past 12 months, stating that the applicant has or has had the specific medical condition, disability or illness.

Applicants will no longer have to wait for a health insurer to send them a denial letter.

‘’The Pre-Existing Condition Insurance Plan changes lives, and in many cases, literally saves lives,” said HHS Secretary Kathleen Sebelius in a statement. “We need to reach more people, and these changes help us do that.”

In addition, beginning this fall, HHS will begin paying agents and brokers to connect people with the PCIP program. This step, the agency said, will help reach those who are eligible but not enrolled.

Applicants still face the requirement of being without health coverage for at least six months before applying.

Cindy Zeldin of the consumer advocacy group Georgians for a Healthy Future applauded the federal moves. “I think it’s a welcome change,’’ she said. “It’s been a little bit surprising how low the enrollment has been.’’

She said the premium cost has been a huge obstacle for the many uninsured adults who are at the poverty line or just above it.

The lowered premiums in the pre-existing condition program will be paid for by the federal government’s original $5 billion allotment  and the premiums that individuals pay. There is no cost to states, federal officials said.

For more information about PCIP, go to www.pcip.gov and click on “Find Your State.”  Or call toll free 1-866-717-5826.

 

 

 

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