On June 14, the Commonwealth Fund released a brief reviewing the national health care reform law’s Pre-Existing Condition Insurance Pool (PCIP) program.  The authors examine high-risk pool enrollment trends, early changes to plan structures and premiums, and out-of-pocket (OOP) cost estimates based on plan type and service utilization.  The authors acknowledge barriers to enrollment, including affordability and beneficiaries’ burden of proof to demonstrate that they have been uninsured for at least six months.  However, the brief argues that the pools are an important transitional program, playing a pivotal role in ensuring coverage until health reform’s exchanges become operational in 2014.

From the report:

The Pre-Existing Condition Insurance Plan (PCIP) is the national, tempo-rary high-risk pool created by the Patient Protection and Affordable Care Act (Affordable Care Act). The program’s purpose is to make health insurance cov-erage available to uninsured individuals with preexisting conditions until 2014, when insurers will no longer be allowed to deny coverage on the basis of health conditions. The health reform legislation mandated that the PCIP program be implemented within 90 days of passage and gave states the option of administer-ing their own programs or allowing the federal government to do so. Currently, 27 states administer their PCIPs, while 23 states and the District of Columbia have federally administered programs.

Full Report: Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable (PDF | 546 KB)

Commonwealth Fund. (2011). Early implementation of pre-existing condition insurance plans: providing an interim safety net for the uninsurable.