PCIP Too Popular, Closes For New Enrollees

Here’s a report from our colleague Elizabeth Abbott about the Pre-Existing Condition Insurance Program, a “bridge” program in the Affordable Care Act for those denied for private insurance due to health status..

A considerable part of the MRMIB Board Meeting on February 20 focused on the directive from the Center for Medicare and Medicaid Services (CMS) to California to suspend enrollment in the Pre-Existing Condition Insurance Plan (PCIP).

This enrollment suspension applies to applications received by the state of California after March 2, 2013 (after this coming Saturday). CMS has announced this nationwide suspension of enrollment to assure that there are sufficient funds available throughout 2013 to continuously cover people currently enrolled in PCIP through the period when the program is already scheduled to end in December.

There are only two exceptions to this suspension:

· CA will still enroll people after March 2 if the individual is currently enrolled in a PCIP program in another state and they move to California

· CA will continue to screen applications submitted after March 2 to see if the individual qualifies for the state’s own high risk pool, the Major Risk Medical Insurance Program, MRMIP

The current PCIP enrollees will remain covered and will receive services through December 31, 2013.

As you know, PCIP was established as a temporary program for people who were unable to secure coverage in the insurance marketplace. Starting January 1, 2014, there will no longer be a need for PCIP because the Affordable Care Act does not allow insurers to deny individuals with pre-existing conditions or charge them higher rates than those without such conditions. Also, the California Exchange, “Covered California” will be open for business in January for both individuals and small businesses to buy affordable health benefits plans.

The deman for the PCIP program has outstripped expectations. While it was always considered only a transition program, this shows the great need for help, and that 2014 and the ACA’s reforms can’t come soon enough.

Health Access California promotes quality, affordable health care for all Californians.
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