Healthcare Business News

Pre-Existing Condition Insurance Plan extended until April 30

By Virgil Dickson
Posted: March 14, 2014 - 3:00 pm ET

The Obama administration is extending for the third time a safety net insurance program for Americans with pre-existing conditions to give them more time to sign up for a standard health plan though the insurance exchanges.

The administration said it would extend the Pre-Existing Condition Insurance Plan, which was slated to end March 15, until April 30. In the extension notice, HHS warned “time is running out,” and pushed the remaining PCIP members to sign up for an exchange plan before open enrollment ends March. 31.

“As part of our continuing effort to help smooth consumers' transition into Marketplace coverage, we are allowing those covered by PCIP additional time to shop for new coverage while they receive the ongoing care and treatment they need,” HHS said in a written statement.

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The PCIP was created by the Patient Protection and Affordable Care Act for uninsured Americans with pre-existing conditions who previously had been unable to obtain affordable coverage. The temporary program was expected to help people living with such conditions as diabetes, asthma, cancer and HIV/AIDS, who often struggled to find affordable coverage, or any coverage. The program, created in 2010, was meant to serve as a bridge until plans on the exchanges began coverage Jan. 1, 2014.

Just over 20,000 people are in the PCIP program now. At its peak it covered more than 135,000 beneficiaries. This is the second extension. It was originally scheduled to end Jan. 31.

Patient advocates were pleased with the extension but echoed the administration's advice that the remaining people find a plan quickly. “We encourage patients in PCIP to look at other insurance options, including the health insurance marketplace at, as soon as possible so they are assured of coverage beyond the short term,” said Alissa Crispino, associate director for media advocacy at the American Cancer Society Cancer Action Network.

It's unclear why some PCIP enrollees have yet to transition to an exchange plan. Experts say the reasons could range from the current system being slow to recognize when a PCIP beneficiary has obtained new coverage to the possibility raised by HHS that some enrollees may be in the middle of treatment and would not be able to keep the same providers after they switch.

The ACA funded the plan with $5 billion from 2010 to 2014. HHS stopped allowing new people to enroll in the program in early 2013 because it had concerns there weren't enough funds to cover the people in the program at that point.

On Friday, HHS officials said there was still some money left over and that those funds were being used to find the extension. A spokesman did not disclose how much funding is left.

Last year, some congressional Republicans proposed a bill that would have provided up to $3.6 billion in additional funds for the program, but it died after facing bipartisan opposition. Conservative Republicans didn't want to encourage any further government involvement in healthcare while Democrats opposed the idea of pulling money from the ACA's Prevention and Public Health Fund for the PCIP program.

Follow Virgil Dickson on Twitter: @MHvdickson

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