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HHS Moves to Make High Risk Pool Slightly More Accessible

Administration of High Risk Pools

Administration of High Risk Pools


In a move that should provide some help to relatively few additional Americans the HHS is making changes to the high risk pools created by the Affordable Care Act. The Pre-Existing Condition Insurance Plan will have its premiums reduced and eligibility restrictions loosened. From the Huffington Post:

To boost enrollment, Sebelius said monthly premiums, which vary by age and region, will drop in 17 of the states where HHS runs the program starting in July. In Alabama, Arizona, Delaware, Florida, Kentucky, and Virginia, premiums will plummet by 40 percent. Come July, people older than 55 who enroll in the Virginia PCIP’s standard plan will have to pay $297 a month, a steep drop from the current $498 monthly premium.

Sebelius also said PCIP applicants will no longer have to brandish rejection letters from insurance companies to prove they have pre-existing conditions. Instead, a doctor’s note will suffice.

Currently PCIP only provides insurance to roughly 18,000 people. This move should help modestly boast the number getting insurance through the program but the HHS will probably still need to maintain a difficult balancing act to prevent too many more people from signing up.

The ACA only provide $5 billion in funding for the high risk pools, which according to the Center for Medicare and Medicaid Services would be insufficient to keep the program going until 2014, if total national enrollment reaches even the low six figures (PDF). Given the both the current anti-spending and anti-Obamacare mood in the House of Representatives, it is safe to assume Congress is unlikely to appropriated any more money to the program if it ran out of funds early.

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Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at