Realizing Health Reform's Potential: Pre-Existing Condition Insurance Plans Created by the Affordable Care Act of 2010

October 4, 2010 | Volume 100

Authors: Jean P. Hall, Ph.D., and Janice Moore, M.A., M.S.W., M.B.A.
Contact: Jean P. Hall, Ph.D., Associate Research Professor, University of Kansas, jhall@ku.edu
Editor: Deborah Lorber

Overview

The Patient Protection and Affordable Care Act includes a provision for the establishment of a temporary high-risk pool, also called the Pre-Existing Condition Insurance Plan (PCIP), to quickly make health insurance available to uninsured individuals with preexisting conditions, many of whom previously had been denied coverage. Twenty-seven states elected to administer the PCIPs for their citizens, while the remaining states and the District of Columbia chose to let their PCIPs be federally administered. This issue brief examines eligibility, benefits, premiums, cost-sharing, and oversight of the PCIP programs, as well as variation of the plans from state to state. The PCIPs will run through December 31, 2013, at which time participants will be transitioned to exchange coverage.

Citation

J. P. Hall and J. Moore, Realizing Health Reform's Potential: Pre-Existing Condition Insurance Plans Created by the Affordable Care Act of 2010, The Commonwealth Fund, October 2010.