California’s Pre-existing Health Condition Plan Gets New Funds

California will receive $118 million in federal funds to add to its 2012 coverage of adults with pre-existing medical conditions.
The state-run, federally funded Pre-Existing Condition Insurance Plan was created last year to insure the uninsurable – those who because of their medical conditions have been denied coverage by insurers or who have had to pay prohibitive insurance premiums to ensure they were covered.
The plan acts as a bridge to 2014, when the federal health care overhaul will begin barring carriers from declining or tacking higher rates onto coverage for pre-existing conditions. With the new funding, the federal contribution to the state program rose to $347 million. Officials at the state’s Managed Risk Medical Insurance Board, which operates the program, said the cash was needed both to expand the program and to keep pace with the cost of subscriber claims. Enrollment in the California plan – among the nation’s largest – stood at 5,972 members as of the end of November.
Monthly per-member costs have grown to more than three times the initial projections. Without the additional money, enrollment in the program would have been capped at 6,800 through the end of 2013.
Similar plans are now in place across the country. The coverage for pre-existing conditions was one of the first major provisions to go into effect across the country after the March 2010 signing of the Affordable Care Act. The plan covers primary, specialty and hospital care as well as prescription drugs and other benefits.

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