Health Care Reform’s Pre-Existing Condition Insurance Plan Covers Fewer Than 50,000 of Millions With Pre-Existing Conditions

The Affordable Care Act created the new temporary Pre-Existing Condition Insurance Plan (PCIP) program to make health insurance available through 2014 to millions of Americans unable to get private health insurance due to pre-existing conditions through 2014.

Although the temporary the PCIP program began accepting applications for enrollment July, 2010 (July 1, 2010 for the federal program, dates for state programs varied), a recent report shows that very few Americans to date are receiving coverage from this program.

As of August 31, 2011, a recent report shows the PCIP Program only covered 33,958 people.  The following chart released October 14, 2011 by the Department of Health & Human Services shows the persons covered by the PCIP Program as of August 31, 2011 broken down by state

*MassachusettsandVermontare guarantee issue states that have already implemented many of the broader market reforms included in the Affordable Care Act that take effect in 2014.  Existing commercial plans offering guaranteed coverage at premiums comparable to PCIP are already available in both states.

** Enrollment appears to have decreased in the New Jersey PCIP. However, this is attributable to a reporting error that affected prior months’ enrollment reports.

• July 31, 2011 enrollment data available here
• June 30, 2011 enrollment data available here
• May 31, 2011 enrollment data available here
• April 30, 2011 enrollment data available here
• March 31, 2011 enrollment data available here  
• February 1, 2011 enrollment data available here

 Join Project COPE To Continue Discussion & Help Promote Meaningful Health Care Reforms To Improve U.S. Healthcare

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. 

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources

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