The Pre-Existing Condition Plan (PCIP) - passed as part of ObamaCare (PPACA) as a stopgap measure until January, 2014 rolled around - was originally projected to serve almost 400,000 people. It's ended up enrolling just about 100,000, but at a cost far, far beyond that which was initially projected.

The average cost for an enrollee in 2012 was $32,108...
The upshot of this is that yesterday the administration announced it would close enrollment in the program effective immediately to preserve remaining funds so as to be able to treat existing enrollees until January 1, 2014. (At that point those enrolled will, in theory, be able to obtain insurance on the PPACA's new health exchanges.)
The Obama administration on Friday said it would stop enrolling new beneficiaries in a special $5 billion insurance program for people with pre-existing medical conditions, because of rising costs and limited funding...

The U.S. Department of Health and Human Services issued a notice on Friday saying it would suspend new enrollments beginning on Saturday to "help ensure that funds are available through 2013 to continuously cover people currently enrolled in PCIP."

The PCIP plan allowed those with pre-existing conditions who could afford the premiums (varying from some $200 to $600+ a month depending on age and state), and who had been without insurance for six months, to obtain health insurance when private insurers either refused coverage or charged incredibly high premiums.

The PCIP has been a godsend to some - a number of lives have undoubtedly been saved due to the program, some on this site even - while for others it was an unattainable form of relief; either people could not afford the premiums or they were locked into an existing, high-cost insurance policy which they didn't dare go off of for six months in order to qualify.

Either way, no longer will anyone have this program as an option.

One of the most frustrating things about the administration's decision to close enrollment is that they have not even tried to obtain more funding.

Asked why the administration has not requested additional money from Congress to keep the program open - admittedly a tough sell in the current political and budgetary environment - Cohen ((director of the Department of Health and Human Services' Center for Consumer Information and Insurance Oversight)) said, "My responsibility is to work with the appropriation we have."
Sure, it probably couldn't have passed through a Tea Party House, but they could have at least tried. I don't know exactly how much additional funding would have been needed, but since $5 billion was allocated initially for a 3.5 year program another $1 billion - hardly real money -
A billion here, a billion there, and pretty soon you're talking real money?
would probably have kept the program able to enroll people who needed it until December, 2013, just nine months away now. In truth, it seems like it should be much less than that. According to the Washington Post
Of the original $5 billion, about $2.36 billion remains available for the last three quarters of 2013 - enough only to continue coverage for those already in the pools, according to administration estimates.
If you believe in math that means it is going to cost about $24,000 per existing enrollee to keep the system running through December. At that rate, $1 billion additional would be able to deal with almost 42,000 more enrollees, far more than would be expected to be added given the historical rate of enrollment. $500 million would probably be more than enough to keep the program able to accept all the new enrollees expected.  The government probably has far more that that lying around that it doesn't even know about.

If Tea Party Republicans want to vote down an additional relatively small amount of money to help ten or twenty thousand people up through the end of this year they should be made to do so. Instead of giving up with barely a whisper the administration should have been fighting hard to keep it going. The program is up, it's running, and it works. That should have been enough to keep it available for all who qualify until its intended end.


This topic was also covered yesterday morning in an awesome diary, but I thought it was worth a repeat with a slightly different perspective at an evening hour.

Originally posted to jpmassar on Sun Feb 17, 2013 at 06:48 PM PST.

Also republished by Progressive Policy Zone, Single Payer: The Fight for Medicare for All, and Healthcare Reform - We've Only Just Begun.

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