HHS: 18 states to drop PCIP programs | LifeHealthPro.
PCIP is the pre-existing condition insurance plan that is running out of money. The goal of the PCIP was to provide coverage to individuals who were not eligible due to pre-existing conditions until the Afforadable Care Act (Obamacare) plans start in January of 2014.
Earlier in the month, HHS sent out a letter detailing additional financial obligation that would fall to the states that were administering their own programs (in many states the Federal Government was running the entire program).So in response, most of the states are washing their hands of the program and handing it over to the Feds.
States and local nonprofits have been running PCIP programs in 27 states, and HHS has been providing PCIP coverage in the other states.About 100,000 people now participate in the program nationwide.
Enrollment has been much lower than originally predicted, but PCIP managers say the enrollees’ claims have turned out to be far higher than expected. The original funding is running out, and Congress has refused to provide more cash.
To stretch the remaing funds…
HHS officials have said that they have been taking a number of painful measures, such as reducing PCIP provider reimbursement levels to just 100 percent of the Medicare rate and requiring enrollees to switch provider networks, to make PCIP funding last until the end of the year.
Yikes. And the “you can keep your doctor” mantra goes away in a budget crunch.
As you can see, the government knows nothing about running an insurance program or the concept of adverse selection and had no idea how to forecast what the PCIP risk pool was going to look like. At least with Obamacare, coverage is “required” although the young invincables may revolt which would lead to budget issues.
