GOP Bill Would Extend ACA’s Temporary High-Risk Insurance Program

House Republicans are fast-tracking a new bill (HR 1549) that would boost funding for the Affordable Care Act's temporary high-risk insurance pool program and keep the program open through the end of this year, The Hill's "Healthwatch" reports.

The legislation was introduced Monday and is scheduled for a mark-up Wednesday in the House Energy and Commerce Committee (Viebeck, "Healthwatch," The Hill, 4/16).

About PCIP

The Pre-Existing Condition Insurance Plan was designed to help sick U.S. residents gain coverage ahead of January 2014, when the ACA's ban on denying individuals coverage because of pre-existing conditions is set to take effect.

In February, the administration announced several cost-saving reforms intended to prevent the $5 billion program from running out of money. HHS later said it was halting enrollment in the high-risk pools because only enough funds remained to cover the 100,000 current enrollees (California Healthline, 2/19).

Republicans on the House Energy and Commerce Subcommittee on Health introduced the bill after Obama failed to respond to a letter from House GOP leaders last month asking him to transfer funding from other ACA programs without congressional action ("Healthwatch," The Hill, 4/16).

About the Bill

HR 1549 would shift about $4 billion from the ACA's Public Health and Prevention Fund to facilitate the extended period of enrollment in PCIP. The measure also would eliminate the ACA requirement that individuals be uninsured for at least six months before they can be eligible for coverage in PCIP (Ethridge, CQ Roll Call, 4/16).

Rep. Joe Pitts (R-Pa.) -- chair of the subcommittee and the bill's lead sponsor -- said, "Since the White House hasn't answered our appeal, we've introduced legislation that would ensure that Americans with pre-existing conditions can once again have access to this program," adding, "Sick Americans without insurance face lots of hurdles to find good coverage" ("Healthwatch," The Hill, 4/16).

Public Health Fund Money Already Earmarked for Other Uses

The Obama administration already plans to allocate money from the Public Health and Prevention Fund for other ACA-related purposes, an HHS official noted in a statement, CQ Roll Call reports (CQ Roll Call, 4/16).

Last week, CMS opened the grant-application process to help fund the ACA insurance exchange navigators program. The administration said it would use money allocated for FY 2013 in the Prevention and Public Health Fund to pay for the navigators to provide guidance to individuals enrolling in the federal and partnership exchanges.

Each exchange must have two certified navigators, one of which must be a not-for-profit. CMS said it expects to distribute up to $54 million to fund navigators for one year (California Healthline, 4/15).

The official wrote, "Because Congress did not provide the resources requested by the administration for implementation of the marketplaces to fully enable individuals to access affordable health care, the department is leveraging and reallocating existing resources from multiple sources to provide short term and immediate funding for [this] effort" (CQ Roll Call, 4/16).