Short Takes On News & Events

GOP Members Call For Increased Spending To Cover Pre-Existing Conditions

By Phil Galewitz

April 3rd, 2013, 4:51 PM

Republicans who have spent the past three years blasting the health care overhaul as an overreach by the federal government said Wednesday the law didn’t allocate nearly enough money for a temporary program offering insurance coverage to those with pre-existing conditions.

Citing financial concerns, the Obama administration last month stopped enrolling new people into the Pre-existing Condition Insurance Plan (PCIP). Enrollment had been scheduled to run through the end of the year when participants would be able to buy insurance in new online marketplaces that prohibit insurers from denying coverage or charging higher prices to people based on their health status.  About 135,000 people have enrolled in the PCIP program, or about a third of what had been projected by the federal government.

Rep. Joe Pitts, R-Pa., chairman of the House Energy and Commerce Health subcommittee, said the program should have allocated the $25 billion he said Republicans pushed for when the health overhaul was debated in 2009.

Rep. Michael Burgess, R-Texas, said Congress should have appropriated $30 billion. “These costs are but a drop in the bucket compared to the whole Affordable Care Act,” Burgess said at a subcommittee hearing examining why the program closed enrollment earlier than expected.

Republicans have asked President Barack Obama to redirect funding from other parts of the health law to the PCIP program to allow it to continue accepting new enrollees.  Pitts said the White House has not responded.

PCIP enrollment was held down because of the requirement that people must have gone without health coverage for at least six months and because premiums were still unaffordable for some consumers, testified Sara Collins, vice president of The Commonwealth Fund, a research group.  Costs were also higher than projected because the pools attracted very sick people, including those with cancer, heart disease and diabetes. About 4.4 percent of enrollees accounted for more than half of the claims paid, she said.

“The program has been a critical bridge to 2014, but its limitations demonstrate why high-risk pools are an inadequate substitute for the comprehensive insurance market reforms and expanded health insurance options to go into effect under the Affordable Care Act next January,” she said.

No Democrats attended Wednesday’s hearing. But in a statement, the full committee’s ranking member Rep. Henry Waxman, D-Calif., said the program’s higher costs were not unexpected.  “If my Republican friends truly share the goal of caring for sick and chronically ill Americans, they will work with us to ensure a smooth transition to 2014 rather than attacking PCIP,” he said.

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