The state Insurance Department is asking the federal government to reconsider proposed changes to a program that's been providing discount health insurance to thousands of "high-risk" Pennsylvanians through the federal health care overhaul -- changes that could cost the state money or shift patient coverage to another plan.
Since October 2010, Pennsylvania's PA Fair Care program has been available to people who don't have coverage through an employer, and who have a health history that makes it difficult for them to afford individual policies on the open market.
Today, according to the state, the program serves about 6,900 Pennsylvanians.
The federal health care overhaul legislation staked the states $5 billion to run these programs through at least 2013, when the online health insurance exchanges are kicking in.
But that $5 billion wasn't enough, and now the federal government is asking states to either agree to a limited amount of funding through the remainder of the year -- and bear the risk of any potential cost overages -- or to move people off state programs and into the federally administered high-risk, pre-existing condition plan.
Pennsylvania Gov. Tom Corbett's administration wants to do neither and instead wants the federal government to continue paying the full, uncapped cost of the PA Fair Care program.
Moving people off one plan and into another would be unnecessarily disruptive, Insurance Department commissioner Michael Consedine said in a letter sent last week to the Centers for Medicare and Medicaid Services, or CMS.
"Gov. Corbett and I respectfully request that you allow PA Fair Care to continue under the [initial] terms," the letter reads. The proposed changes to the program amount to "an abrupt ultimatum" that will cause "confusion and disruption for this vulnerable population," according to the letter.
Two months ago, CMS suspended all new enrollment in PA Fair Care and the high-risk plans operated in other states. The month before, the federal government suspended new enrollment in its own high-risk plan, but, like the states, is still paying for the coverage of current enrollees.
While some of the state-run plans suffered from low enrollment, Pennsylvania's is a standout, enrolling thousands while keeping premiums at a market competitive rate of $283 a month for an individual.
In 2010, the Obama administration estimated that as many of 375,000 would get coverage through either the states' or the federal government's versions of the pre-existing condition health plan. The Congressional Budget Office predicted even more enrollees.
But as of February 2013, nationwide enrollment was only at 110,000, yet the program was still running out of money.
In April, U.S. House Republicans, including primary sponsor Rep. Joe Pitts, R-Lancaster, announced a plan to steer some $3.6 billion of "Obamacare's" marketing and preventive health fund toward the high-risk plans.
But that bill would have to get past the president's desk before the insurance fund would see any new money, and President Barack Obama has said he would veto it.
First Published: May 15, 2013, 4:00 a.m.
Updated: May 15, 2013, 9:37 a.m.
