Posted: 2:51 p.m. Thursday, Dec. 12, 2013
By Phil Galewitz
About 85,000 people with a history of serious illness, who are still enrolled in high-risk insurance pools created under the health care law, will get a month’s reprieve before they lose that coverage.
The Pre-Existing Condition Insurance Plan (PCIP) — scheduled to close at the end of the year — is being extended until the end of January 2014, the Obama administration said Thursday. The plans, which started in 2010, have helped people with pre-existing conditions obtain health coverage.
“We want to ensure that PCIP enrollees do not experience a lapse in coverage because many are currently receiving regular treatments for such diseases as cancer, diabetes, and heart disease,” the Centers for Medicare & Medicaid Services said in a statement.
The program was supposed to end Dec. 31 because insurers will no longer be able to reject people or charge them higher rates as a result of their medical history. But many PCIP members have had trouble enrolling in new coverage due to the troubled launch of healthcare.gov and other state online exchanges.
State-run high risk pools are also considering extending their programs.
Consumer advocacy groups hailed the decision.
"Extending the Pre-Existing Condition Insurance Plan will give tens of thousands of people with a history of cancer or another serious disease the security of knowing they will not face a costly gap in coverage on Jan. 1, if they cannot enroll in a marketplace plan by Dec. 23,” said American Cancer Society Cancer Action Network President Chris Hansen.
Hansen said that those with chronic diseases must carefully weigh their choice of plans, looking not just at premiums and other out-of-pocket costs, but also at prescription drug coverage and financial assistance options.
“Extending coverage under PCIP gives patients valuable additional time to select the marketplace plan that best meets their unique needs,” Hansen said.
The PCIP program has helped more than 135,000 Americans since it began in late 2010. The federal program suspended acceptance of new enrollees in mid-February, while state-based pools closed their doors on March 2 because of funding concerns.
Consumers generally must sign up for coverage in the new online marketplaces by Dec. 23 to have insurance that takes effect Jan. 1. Enrollment in the marketplaces continues through March, although some think it could be extended because so many people had difficulties using the website.
CMS spokesman Aaron Albright said the administration is continuing to look at ways to make the enrollment process easier for all consumers, including those in the high-risk pools.
“As part of our efforts to smooth the transition to the marketplaces for those seeking coverage that begins in January, we are taking steps to ensure that Americans enrolled in the federal PCIP insurance plan will not face a lapse when the new year begins,” he said.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.