Enrollment in the Pre-Existing Condition Insurance Plan, part of President Obama’s larger Patient Protection and Affordable Care Act, has been far lower than anticipated. The program was initiated to serve as a bridge for the more than 25 million Americans who have suffered from a condition that prevents them from buying private health insurance until health care exchanges are put into place in early 2014.

To date, however, fewer than 34,000 people have enrolled. These low participation numbers can in part be explained by high cost: PCIP offers market-rate insurance premiums, which many can’t afford. An even bigger obstacle, though, is likely the six month waiting period imposed by the program. Enrollees must be able to prove that they have not been able to purchase private coverage for six months or more, a risk that many with health concerns are not willing to take.

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