California Nabs $118M To Bolster Pre-Existing Condition Insurance

TOPIC ALERT:

California will receive an extra $118 million in federal funding to help expand coverage in the state's Pre-Existing Condition Insurance Plan, the Sacramento Bee reports (Smith, Sacramento Bee, 12/20).

Background

PCIP provides coverage to individuals with pre-existing conditions until 2014, when the federal health reform law mandates that private insurers accept all applicants regardless of pre-existing conditions.

To qualify for coverage in PCIP, an applicant must be a U.S. citizen or documented resident, have lacked medical coverage in the past six months and have a medical condition that could warrant denial of coverage (California Healthline, 10/28).

How the Funding Affects PCIP

The new funds bring the total federal contribution to California's PCIP to $347 million.

According to officials at the state Managed Risk Medical Insurance Board, which runs PCIP, the funds were needed to expand the program and keep up with the costs of claims. Monthly costs per member have risen more than threefold from what was initially estimated.

Sarah Smith -- a spokesperson for MRMIB -- said that PCIP enrollment at the end of November was 5,972. If California had not received the additional funds, enrollment would have been capped at 6,800 through December 2013 (Sacramento Bee, 12/20).

For additional coverage on the new federal funding for PCIP, see last Thursday's Capitol Desk post.


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