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PPACA: More PCIP Programs Open Doors

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Pre-exising Condition Insurance Plan programs in Pennsylvania and Washington state are coming online.

The Pennsylvania PCIP program, the PA Fair Care program, will be up and running later this week, according to Pennsylvania Insurance Commissioner Joel Ario.

Highmark Blue Shield, a unit of Highmark Inc., Pittsburgh, will administer the PA Fair Care program.

Premiums for the federal temporary risk pool program will be $283.20 a month, officials say.

Officials believe the program has initial funding to serve about 3,500 individuals. Eligible applicants will be enrolled on a first-come, first-served basis.

In Washington state, the Washington State Health Insurance Pool, an entity that already runs a state high-risk pool, has started taking applications for that state’s federal temporary high risk pool program.

The Washington state program is getting a $102 million grant.

Coverage for accepted applicants who apply by Aug. 15 will start Sept. 1, officials say.

The federal Affordable Care Act (ACA) – the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) – provides $5 billion in PCIP funding to fill in coverage gaps for uninsured people with health problems before a ban on medical underwriting takes effect in 2014.

The ACA PCIP provisions require PCIP premiums to be comparable to commercial premiums. Age, geographic location and tobacco use are the only factors that a PCIP program can use when setting rates.

Many states and the District of Columbia will be running their own risk pool plans; other states are letting the U.S. Department of Health and Human Services provide risk pool coverage for their residents.


CORRECTION: An earlier version of this article described the status of the Pennsylvania PCIP program incorrectly. The Pennsylvania program will be accepting applications later this week.


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