Today, Congressman Alcee L. Hastings (D-Miramar) introduced 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). 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 nineteen 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. Hastings' legislation will eliminate the 6 month wait period and exclude mini medical plans from creditable coverage in relation to eligibility requirements for the PCIP program.
"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. 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.
"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.
"My legislation will address these serious issues and bring us one step closer to ensuring accessible, affordable, and quality health care for all Americans."