HHS Extends Pre-Existing Condition Insurance Plan Until March 31

On Tuesday, the Obama administration announced that it is extending by two months -- until March 31 -- a federally sponsored high-risk health insurance pools program for individuals with serious illnesses, the Wall Street Journal reports (Radnofsky, Wall Street Journal, 1/14).

The program -- called the Pre-Existing Condition Insurance Plan -- was designed to help sick U.S. residents gain coverage ahead of January 2014, when the Affordable Care Act's ban on denying individuals coverage because of pre-existing conditions took effect (California Healthline, 5/9/13). The program, which has been providing coverage to about 100,000 U.S. residents nationwide, was originally scheduled to end on Dec. 31, 2013, when enrollees would have transitioned to private health plans in the ACA's insurance exchanges (CQ HealthBeat, 11/12/13).

However, HHS Secretary Kathleen Sebelius in December 2013 announced that the department had extended PCIP by one month -- through the end of January 2014. The decision was one of three ACA policy changes to ease consumers' transition to coverage in the new marketplaces in 2014. Sebelius said many consumers needed more time to select and pay for their new coverage because of the technical issues that plagued the online marketplace, particularly the federal health insurance exchange website (California Healthline, 12/13/13).

In an email statement on Tuesday, HHS spokesperson Erin Shields Britt described the additional two-month extension "as part of our continuing effort to help smooth consumers' transition into marketplace coverage" (Carey, Kaiser Health News, 1/14).

According to the New York Times, there still are about 30,000 people in PCIP. Those enrollees will now have until March 15 to sign up for new coverage in the exchanges that would begin April 1, ensuring that there will be no coverage gap when PCIP ends (Pear, New York Times, 1/15). The federal government's decision also will give states that are running their own PCIP-style programs the option of extending coverage until March 31.

According to Kaiser Health News, the cost of the extension will be paid for with the remainder of the $5 billion that had been appropriated for the program. To date, the government has spent more than $4.7 billion of that amount (Kaiser Health News, 1/14).