Low Enrollment for Pre-Existing Condition Insurance Plan

One of the biggest obstacles with obtaining health care was the limited access that people with pre-existing conditions had to health care coverage.  A new plan – the Pre-Existing Condition Insurance Plan – was launched this summer as part of the Affordable Care Act. It’s meant to provide access to health care for those denied coverage due to pre-existing conditions.

To meet the criteria, a person must have problems getting health insurance because of a medical condition and have been uninsured for at least six months.

When putting together this plan, government economists predicted 375,000 people would enroll and gain coverage this year alone. They questioned if the $5 billion allotted for this program would be sufficient.

It turns out it’s more than sufficient.

Many people aren’t signing up for the program. In many states, enrollment is far below what was predicted. California has received fewer than 450 applications, despite having enough resources to cover 20,000. Texas has enrolled only around 200, while Wisconsin has received fewer than 300 applications for the 8,000-person program.

According to experts, the premiums for these plans are unaffordable for many people. The premiums, while on par with rates that an average healthy person would pay, is not exactly cheap with a premium of $400 to $600 a month for those in their 40s and 50s in many states.

People that may be eligible are unable to foot the monthly premium bill.  The exceptions are states like Pennsylvania, which set a lower premium - $283 – for people of any age. They had no issue in getting applicants to apply for their plan.

Another issue that experts brought up is plan coverage. In states with plans that are federally-run, the plan doesn’t provide coverage for prescription drugs until plan members have met a $2,500 annual deductible.

For many, the Pre-Existing Condition Insurance Plan may only be worth it for the most catastrophic cases, where medical bills could result in the thousands.

This program will last until 2014, when the new law requires every plan to accept all applicants regardless of their medical history. This could possibly foreshadow future problems with other major changes in the new law.