PCIP Enrollment Numbers Rise a Bit

The federally funded, state-run Pre-Existing Condition Insurance Plan has always been a bit of a tough sell.

It costs money, for one thing (premiums vary according to age and geography). And eligibility can be challenging: you have to have a pre-existing condition and be uninsured for six months.

That last requirement may be the toughest hurdle because those people with pre-existing conditions that are severe enough to be denied private insurance would have a hard time going uninsured for half a year.

“The barrier of being six months uninsured, that’s a hard barrier to cross,” board member Shelley Rouillard said at this week’s meeting of the Managed Risk Medical Insurance Board, which oversees the PCIP program.

In the first year after the program launched in October 2010, it added about 375 enrollees a month. At the one-year mark, enrollment stood at about 5,000 Californians.

That was a far cry from early guesses about how many people would sign up. The capacity of the program was originally estimated at 23,000, so it has been an ongoing concern for MRMIB officials that the enrollment growth rate has been relatively mild.

Recently, those numbers have climbed. In the past couple of months, new enrollees topped 700 a month, and rose above 800 in the past month.

That’s the result of several factors: an increase in fees for insurance brokers; the recent lowering of PCIP premium rates by the feds; and a large marketing and outreach program launched by the PCIP staff.

“We’re now number one in the nation,” Ernesto Sanchez, PCIP’s deputy director for eligibility, enrollment and marketing, reported to the board. “We’ve been shooting for that ever since we started the program.”

Outreach has included newsletters, updates on Twitter and Facebook, continuing education classes for insurance agents and brokers and publication of PCIP articles by disease-specific organizations. The big-ticket item, though, was the launch of a PCIP advertising campaign on radio, billboards, provider publications and in-pharmacy audio.

Elizabeth Abbott of Health Access California, who attended this week’s board meeting, said she was heartened by the increase in enrollee rate — and wishes it were higher.

“You have put out a major outreach coordinated campaign,” Abbott said, “and I was hoping these [enrollment] numbers would go through the roof. It’s up a little bit, but not multiples. … I urge you to do everything you can to increase that enrollment.”

The recent bump up in numbers came at a time when the state had just revised its estimate of PCIP capacity. With its first real claims numbers to go on, the original estimate of 23,000 possible enrollees was rolled back to a maximum of 6,800. All of that changed at this week’s meeting, when officials announced that the federal government upped its annual funding of the PCIP effort.

“And I would note, when I talked with them,” MRMIB Executive Director Janette Casillas said, “they had very nice things to say about our PCIP program.”

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