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Another Day, Another Month More for High-Risk Pools


Jason Millman of Wonkblog reports that the Obama administration will continue a federal high-risk pool program (called “PCIP”) that was intended to cover Americans too sick to qualify for or afford insurance before the Affordable Care Act’s exchanges, which have to offer insurance to anyone, opened.

Secretary Sebelius was adamant yesterday that there was no absolutely no way the White House was extending the deadline for purchasing health insurance on the exchanges, now they have to do just that for people who stay on PCIP through April.

The federal high-risk pool complemented a variety of state programs that did the same thing at significant expense to their states, but they all ended on December 31 when coverage for the exchanges opened. This is the third time HHS has extended the program: First we heard in mid-December that those with insurance from the high-risk pool would be covered through January, since some very sick people who had insurance weren’t able to get it through the exchanges despite three months of open enrollment. It was announced in January that the plans could be extended through March; now they’ll last through April 30.

Millman notes that “the White House is standing by the March 31 deadline for enrollment, but the administration’s announcement shows that officials are carving out more exceptions to it.” Which means the White House isn’t standing by it, really — extending PCIP, which covers about 100,000 people, means they’ll presumably be eligible to buy plans on the exchanges in April, with coverage starting May 1. It’s a small crack in the declaration they were making yesterday, but one nonetheless. (People who lose insurance for whatever reason at some point in the rest of the year can get on the exchanges whenever, of course; the open-enrollment deadline doesn’t apply to them. But this weakening of the deadline is ad hoc and of the White House’s own making.)

As I wrote back in January when the high-risk program was extended through March, the Obama administration’s reliance on these programs has some irony: Conservatives who aim for universal coverage like high-risk pools, since they can ensure, with some state subsidies, that very sick people can get insurance coverage without upending the entire insurance system as the ACA does. When the ACA’s high-risk pool ran out of money, in fact, Majority Leader Eric Cantor proposed adding in more funds from less-useful Obamacare programs to get sick people coverage.