FOR IMMEDIATE RELEASE
May 31, 2011
Contact: HHS Press Office
(202) 690-6343
HHS to Reduce Premiums, Make it Easier for Americans with
Pre-Existing Conditions to Get Health Insurance
The U.S. Department of Health and Human Services (HHS) today
announced new steps to reduce premiums and make it easier for
Americans to enroll in the Pre-Existing Condition Insurance Plan.
Premiums for the Federally-administered Pre-Existing Condition
Insurance Plan (PCIP) will drop as much as 40 percent in 18 States,
and eligibility standards will be eased in 23 States and the
District of Columbia to ensure more Americans with pre-existing
conditions have access to affordable health insurance. The
Pre-Existing Condition Insurance Plan was created under the
Affordable Care Act and serves as a bridge to 2014 when insurers
will no longer be allowed to deny coverage to people with any
pre-existing condition, like cancer, diabetes, and asthma.
gThe Pre-Existing Condition Insurance Plan changes lives, and in
many cases, literally saves lives,h said HHS Secretary Kathleen
Sebelius. gThese changes will decrease costs and help insure more
Americans.h
In 23 States and the District of Columbia, the PCIP program is
Federally-administered. The remaining States operate their own PCIP
programs using Federal funds provided by the Affordable Care
Act.
Under the changes announced today, PCIP premiums will drop as
much as 40 percent in 18 States where the Federally administered
PCIP operates. These premium decreases help bring PCIP premiums
closer to the rates in each Statefs individual insurance market; in
the six States where PCIP premiums were already well-aligned with
State premiums, premiums will remain the same.
The changes announced today will make enrolling in the
Federally-administered PCIP in 23 States and the District of
Columbia easier. Starting July 1, 2011, 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 on an
insurance company to send them a denial letter. This option became
available to children under age 19 in February, and this pathway is
being extended to all applicants regardless of age. Applicants will
still need to meet other eligibility criteria, including that they
are U.S. citizens or residing in the U.S. legally and that they have
been without health coverage for six months.
HHS also sent letters today to the 27 States running their own
programs to inform them of the opportunity to modify their current
PCIP premiums.
To further enhance the program, beginning this fall, HHS will
begin paying agents and brokers for successfully connecting eligible
people with the PCIP program. This step will help reach those who
are eligible but un-enrolled. Several States have experimented with
such payments with good success. This is a part of continuing HHS
outreach efforts with States, insurers, providers, and agents and
brokers to reach more eligible people and let them know that
coverage is available. HHS is also working with insurers to notify
people about the PCIP option in their State when their application
for health insurance is denied.
Congress created the temporary PCIP program as part of the
Affordable Care Act to help uninsured Americans with a variety of
medical conditions get affordable coverage rather than be locked out
of the system by insurance companies. In 2014 and beyond, insurers
will be prohibited from denying coverage to anyone with a
pre-existing condition and new competitive marketplaces called
Health Insurance Exchanges will give people the opportunity to shop
for the policy that best suits their needs. Millions of Americans
also will receive tax credits to help make coverage affordable.
Enrollment in PCIP programs has begun to grow rapidly. In the
period between November 2010 and March 2011, enrollment in all
programs rose 129 percent to more than 18,000 Americans enrolled in
PCIP.
gThese changes will get more people covered,h said Steven Larsen,
the Director of the Center for Consumer Information and Insurance
Oversight. gWefre encouraged by recent increases in enrollment and
wefre excited to build on these efforts and reach even more
people.h
PCIP provides comprehensive health coverage, including primary
and specialty care, hospital care, prescription drugs, home health
and hospice care, skilled nursing care and preventive health and
maternity care. It limits annual out-of-pocket spending and does not
carve out benefits the people need. Eligibility is not based on
income and people who enroll are not charged a higher premium
because of their medical condition.
To find a chart showing changes to PCIP premiums in the States
with Federally-administered PCIP programs, visit www.HealthCare.gov/news/factsheets/pcip05312011a.html.
For more information, including eligibility, plan benefits and
rates, as well as information on how to apply, visit www.pcip.gov and click on gFind Your
State.h Then select your State from a map of the United States or
from the drop-down menu. The PCIP Call Center is open from 8 a.m. to
11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY
1-866-561-1604).
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Note: All HHS press releases, fact sheets and other press
materials are available at http://www.hhs.gov/news.
Last revised: May 31,
2011
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