Uninsured people with medical conditions will have an easier time paying and qualifying for the Pre-Existing Condition Insurance Plan in many states, according to the U.S. Department of Health and Human Services (HHS). The department announced premiums for the program will drop as much as 40 percent in 18 states, and eligibility standards will be eased in 23 states and the District of Columbia.
The Pre-Existing Condition Insurance Plan was created under the Affordable Care Act and serves as a bridge to 2014 when insurance companies will no longer be allowed to deny coverage to people with medical conditions, such as diabetes, cancer and asthma. The federal government administers the program in 23 states and the District of Columbia; the other 27 states operate their own programs using federal money provided by the health care reform law.
Changes to the federally administered plan
Premium cuts in 18 states, where the federally administered plan operates, bring rates closer to those in each state's individual health insurance market. Premiums will remain the same in the six other states where rates were well-aligned with those in the private market, according to federal health officials.
Starting July 1, people applying for coverage can simply provide a letter from a doctor, physician assistant or nurse practitioner dated within the past 12 months stating that they have or, at any time in the past, had a medical condition, disability or illness. Applicants will no longer have to wait for an insurance company to send them a denial letter.
This option became available to children under age 19 in February, and is now open to all applicants regardless of age. However, other eligibility criteria must be met: applicants must be U.S. citizens or residing in the U.S. legally and must have been without health coverage for six months.
HHS also sent letters to the 27 states running their own programs to inform them of the opportunity to modify their current Pre-existing Condition Insurance Plan premiums.
New agent and broker incentives to increase enrollment
To further enhance the program, HHS will start paying agents and brokers for successfully connecting eligible people with the program. This step will help reach those who are eligible but un-enrolled. Several states have experimented with such payments with good results, federal officials said.
As of March this year, more than 18,000 Americans were enrolled in the Pre-Existing Condition Insurance Plan.
"These changes will get more people covered," Steven Larsen, director of the Center for Consumer Information and Insurance Oversight, said in a press statement. "We're encouraged by recent increases in enrollment and we're excited to build on these efforts and reach even more people."