Lower Premiums Announced for Healthcare Reform High Risk Pools

June 1, 2011

Lagging enrollment reason for the change

The federal government is cutting premiums up to forty percent in states that have elected to have the federal government run their plans. This is in response to the lower than expected enrollment in the Pre-existing Condition Insurance Plan (PCIP). Enrollment is down because individuals cannot afford the premium and the eligibility requirements are too hard to meet. Two requirements that are changing are: people will not need to provide a declination letter from an insurance company and they will only need a letter from a doctor stating they have a "medical condition". The requirement that they have been uninsured for six months prior will still stand. In an example from Florida, the average monthly premium for an individual over age 55 is $390. After July 1, it will drop to $234 a month.

These high-risk pools were designed to provide a temporary option for individuals that were uninsurable until 2014 when insurance companies would be required to insure all and not discriminate against the sick. Currently there are only 18,000 enrolled in the plans. Originally it was estimated that hundreds of thousands would be enrolled prior to 2014 when the program would be phased out.

Check out the June 1, 2011 NAHU Newswire to read more on proposed HHS rules that will allow patient access to electronic medical records.

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