Pa. leads in high-risk insurance enrollment
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Pennsylvania's new "high-risk" insurance plan, meant to provide coverage for uninsured people with pre-existing health conditions, still has room for new enrollees but is dramatically outperforming similar state plans across the country.
So far, more than 1,650 people are enrolled and receiving benefits through the federally subsidized PA Fair Care program, which costs $283 a month. To be eligible, an applicant must be without health insurance for at least six months and must be unable to obtain coverage because of medical conditions.
Pennsylvania's $283 monthly rate, plus co-pays and deductibles, measures favorably against other states, where monthly premiums can reach $972 a month. The take-home message, three months into the program, seems to be that the more affordable the policy is, the more people will buy it.
The state Insurance Department says it has room for up to 3,500 enrollees, meaning that, as of the end of October, Pennsylvania's high-risk program was operating at roughly 50 percent of capacity.
But most states are running at 10 percent capacity or lower, according to statistics provided last week by the U.S. Department of Health and Human Services. In fact, nationwide, only 8,011 have enrolled in the high-risk pools as of Nov. 1.
That means Pennsylvania accounts for more than 20 percent of the nationwide total. It is providing coverage to more people than any other state.
On top of the 1,650 with coverage under the program, an additional 2,300 had applied through the end of October. So far, 1,700 of those are still "pending," meaning they may or may not be eligible.
Six-hundred have already been denied coverage, either because they had no pre-existing condition, they'd had coverage within the six-month window or because they were dropped from the program for other reasons (they couldn't afford the premiums, they found a job and that provided insurance, they were approved for Medicaid coverage, etc.).
"I think there are three reasons that Pennsylvania is doing so well," said Insurance Department spokeswoman Melissa Fox. "First, our premium is more affordable than other states' [because] it is community rated -- spreading the risk among a large group -- and not rated by age or condition."
First Published November 9, 2010 12:00 am
