The Commonwealth Fund has released a brief examining implementation of the national health care reform law's Pre-Existing Condition Insurance Plan (PCIP), the law's high-risk health coverage pools.  The brief examines early enrollment trends and early changes to plan structures and premiums.  The authors also estimate beneficiaries' out-of-pocket (OOP) costs by service utilization and plan type.  Although enrollment thus far has been low, the brief suggests the pools have played an important safety net role in the lead up to full implementation of the national health care reform law.

From the report: 

As a transitional program, the PCIP is playing an important role in making coverage available to otherwise uninsurable Americans with preexisting conditions. Structural elements of the program, including affordability of coverage and the requirement to have been uninsured for six months, are probably barriers to enrollment for many who might otherwise benefit. Nevertheless, increased outreach efforts and additional modifications to plans based on enrollment experience will likely result in continued growth in enrollment. Moreover, for those already enrolled, the PCIP programs are a critical source of bridge coverage until the health insurance exchanges are operational.  An important lesson from examining PCIP programs is the difficulty in comparing costs and coverage across plans in the absence of stricter federal guidelines on plan structure and coverage. The flexibility allowed for PCIP programs was a necessity for meeting the 90-day timeline for implementation, but it should not be a factor in the development of guidelines for the health insurance exchanges. Indeed, uniformity in exchange design will be essential for consumers to make informed decisions about the coverage that will best meet their needs and fit their budgets.

Full report: Realizing Health Reform's Potential: Early Implementation of Pre-Existing Condition Insurance Plans: Providing an Interim Safety Net for the Uninsurable (PDF | 546.37)

Commonwealth Fund.  (2011).  Realizing health reform's potential: early implementation of pre-existing condition insurance plans: providing an interim safety net for the uninsurable.  Hall, J. and Moore, J.