Mr. HASTINGS of Florida. Mr. Speaker, I rise today to introduce the PCIP Improvement Act of 2012, a bill that will make much needed improvements to the Pre-Existing Condition Insurance Plan (PCIP) program, created by the Affordable Care Act (ACA).
As you know, the ACA prohibits insurance companies from refusing to sell coverage or renew policies because of a person's pre-existing condition. While the provision already affects children up to 19 years of age, it will only apply to adults in January 2014. In the meantime, adults with a pre-existing condition can get coverage through the PCIP program, a temporary high-risk pool which has helped over 50,000 previously uninsured individuals get coverage.
While I have always been a strong supporter of this important program, I believe that some improvements need to be made in order to make it a success. Indeed, enrollment has been significantly lower than initial projections, which varied from 200,000 to 375,000. One of the biggest obstacles for enrollment in the program is a Congressional mandate requiring that individuals applying for PCIP coverage have not had creditable insurance coverage during the 6 months prior to the date they apply to the program. Since the program's inception in July 2010, 69 percent of applications have been denied because individuals had creditable coverage within 6 months of applying.
While well-intentioned, this wait period has shown adverse effects by incentivizing people with pre-existing conditions to go uninsured for 6 months to qualify for the program. Individuals who lost their health insurance through no fault of their own and can no longer find coverage must wait 6 months to apply, thus exposing themselves to high out-of-pocket medical costs and unnecessary health risks. Unfortunately, because they go without insurance for such an extended period of time, they enter the program with a need for immediate care and cost more to the program.
Furthermore, considering mini medical plans as creditable coverage also encourages individuals to go with absolutely no coverage for 6 months in order to apply to PCIP. Mini medical plans are basic plans that may pay for portions of a doctor's visit or prescription drug, but do not provide catastrophic coverage or enough benefits for people with pre-existing conditions. Individuals who choose to obtain such a plan within 6 months of applying for PCIP to limit their medical liabilities will no longer be eligible for the program.
Such a misfortune happened to one of my constituents who lost his health insurance when he lost his job and has been denied coverage because of a pre-existing condition since then. In June 2010, he received limited coverage through a mini medical plan that did not cover his pre-existing condition. When he applied to PCIP in September 2011, his application was denied because he had such plan within 6 months of applying. The only way for him to qualify was to go completely uninsured for 6 months. I cannot, in good conscience, advise my constituents in need of immediate care to wait 6 months to seek medical coverage.
Mr. Speaker, this legislation will address these serious issues by eliminating the 6-month wait period and excluding mini medical plans from creditable coverage. My bill will bring us on step closer to ensuring accessible, affordable, and quality health care for all Americans. I urge my colleagues to help make PCIP a more successful program by supporting this important legislation.