Effect of Health Insurance on Americans

The lack of health insurance affects almost 60 million Americans. There are the working poor, who are not provided benefits and cannot afford personal policies, the unemployed who could not afford or have run out of COBRA coverage, and those with pre-existing conditions who cannot find a company to cover them at all, even with an exclusion rider.  For this last group, help is on the way thanks to the Affordable Care Act Program.

As a stopgap measure, the U.S. Department of Health and Human Services (HHS) announced today the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition. The Pre-Existing Condition Insurance Plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition, and are a U.S. citizen or are residing in the United States legally. This plan will bridge the gap until the 2014, when insurers will be barred from from discriminating against adults with pre-existing conditions.

“For too long, Americans with pre-existing conditions have been locked out of our health insurance market,” said HHS Secretary Kathleen Sebelius.  “Today, the Pre-Existing Condition Insurance Plan gives them a new option—the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition.  This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”

The Affordable Care Act provides $5 billion in federal funding to support Pre-Existing Condition Insurance Plans in every state. Some states have requested that the U.S. Department of Health and Human Services run their Pre-Existing Condition Insurance Plan. Other states have requested that they run the program themselves. Starting today, the national Pre-Existing Condition Insurance Plan will be open to applicants in the 21 states where HHS is operating the program. All states which are operating their own Pre-Existing Condition Insurance Plans will begin enrollment by the end of the summer, with many beginning enrollment today.

The Pre-Existing Condition Insurance Plan will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.  The Pre-Existing Condition Insurance Plan does not base eligibility on income and does not charge a higher premium because of a medical condition.  Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.

Information on how to apply for the Pre-Existing Condition Insurance Plan is available at .  Americans who live in a state where the U.S. Department of Health and Human Services is running the Pre-Existing Condition Plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply on .
 

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