Extra Year of Operation for PCIP?

A big topic at yesterday’s meeting of the Managed Risk Medical Insurance Board (MRMIB) was the agency’s interaction with the state’s Health Benefit Exchange.

Programs MRMIB administers will eventually disappear, absorbed by the introduction of health care reform and the Exchange in 2014. That is fine with the board members at MRMIB, but they gently raised the idea yesterday that programs such as the Pre-existing Condition Insurance Plan might be continued for a year.

“This population will migrate to the Exchange, and that’s what we want,” board member Richard Figueroa said. “But also, we do have some things to offer, in terms of what we’ve learned about running a transparent process, the single rules engine, and how to get people into these programs and keep them there.”

In that first year of the Exchange, according to MRMIB executive director Janette Casillas, it could be a good idea to keep the high-cost, high-risk patients in the programs where they currently receive care.

“It might sit better to let the Exchange launch and get a good mix of enrollees in the first year,” Casillas said, “before taking on the PCIP folks.”

That scenario, if the Exchange board thinks it’s desirable, would have to be funded entirely with federal dollars, Casillas said.

Because MRMIB programs have so much in common with the Exchange, Casillas said there are a lot of administrative details to share and questions to raise. She has been in touch with the Exchange staff on a variety of issues, she said.

Other MRMIB News

  • The deficit facing Healthy Families, California’s federally subsidized State Children’s Health Insurance Program administered by MRMIB, has been tabbed at $27 million, according to MRMIB officials. Dealing with that deficit was an action item at yesterday’s meeting, but MRMIB staff is still working on possible solutions.
  • Enrollment in PCIP is up, primarily due to a federal rate reduction in the program. Casillas said PCIP enrollment has been lower than expected across the nation — as it has in California. That’s why federal officials agreed to the premium rate reduction.

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