The Patient Protection and Affordable Care Act is a long, complicated document that will cause real changes in the way that you and your family access and pay for health insurance. Texas Impact is committed to helping you understand the bill and making sure that you get the benefits available to you. In the coming weeks, we will pick apart the bill-- starting with the provisions that go into effect in 2010-- so you can see who will be affected.
Pre-Existing Conditions Insurance Plan (PCIP)
One of the Affordable Care Act’s most important changes to the health insurance system is its provision for individuals who are unable to obtain private health insurance coverage because of pre-existing medical conditions. For the past 12 years in Texas, the High Risk Insurance Pool has served as a “safety net” for those excluded from regular coverage. This year, new federal guidelines under the Affordable Care Act establish a federal insurance pool for the previously uninsurable, run by the U.S. Department of Health and Human Services to run the program instead.
The newly designed federal insurance pool, known as the Pre-Existing Conditions Insurance Plan (PCIP), will allow previously uninsured individuals to obtain insurance, and pay premium rates equal to standard market rates. In order to qualify for the federal plan, one must:
- Be a US citizen, or lawfully present in the US,
- Have been uninsured for at least 6 months,
- Provide a recent (within 6 months) insurance company coverage rejection letter.
The “rolling implementation” of the Affordable Care Act means that by 2014, insurance companies will no longer be able to refuse coverage to those who have historically been considered uninsurable. Twenty-eight states are improving their health insurance systems to include a risk pool, and 22 other states (including Texas) are relying on the federal PCIP to serve as a “stop-gap safety net” for the next four years.
Beginning July 1, applications for the Pre-Existing Conditions Insurance Plan can be submitted, and those who enroll in the plan before July 15 can anticipate coverage beginning August 1.
More information about the plan can be found at www.pcip.gov.
Health Reform Step-by-Step: Free Preventive Care
Health Reform Step-by-Step: Temporary High-Risk Pool
Health Reform Step-by-Step: The Doughnut Hole
Health Reform Step-by-Step: Small Business Tax Credits
Health Reform Step-by-Step: Young Adult Coverage
