HHS reduces premiums for PPACA risk pools

New steps to reduce premiums and make it easier for Americans to enroll in the federally administrated Pre-Existing Condition Insurance Plan risk pool were announced May 31 by the U.S. Department of Health and Human Services.

The PCIP was created under the Affordable Care Act to ensure that Americans with pre-existing health conditions would have access to affordable insurance.

“The Pre-Existing Condition Insurance Plan changes lives, and in many cases, literally saves lives,” says HHS Secretary Kathleen Sebelius in a news release. “These changes will decrease costs and help insure more Americans.”

In 23 states and the nation’s capital the PCIP program is federally administered; the remaining states operate their own programs using federal funds provided by PPACA. As of May 31 premiums dropped in 17 of the states and the District of Columbia where the PCIP operates, in some cases by as much as 40%, according to the news release.

HHS also sent letters on May 31 to 27 states running their own programs to inform them of an opportunity to modify their current PCIP programs. Starting July 1, people applying for coverage can simply provide a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating that they have or, at any time in the past, had a medical condition, disability or illness, the news release notes. In addition, applicants will no longer have to wait for an insurance carrier to send them a denial letter. This option became available to children under age 19 in February, and is now being extended to all applicants regardless of age.

Starting in the fall, HHS will begin paying agents and brokers for successfully connecting eligible people with the PCIP program. This step will help reach those who are eligible but not enrolled. This is a part of continuing HHS outreach efforts with states, insurers, providers, and agents and brokers to reach more eligible people and let them know that coverage is available. For more information about the broker referral payment program, agents and brokers can sign up by submitting their name and email on the PCIP website.

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Healthcare reform
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