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For People With Pre-Existing Conditions, Insurance Prices Matter

Here's a no-brainer: Charge lower rates for health insurance and more people will buy it.

That's one of the lessons gleaned from early enrollment figures in the new federally subsidized program for uninsured people with pre-existing conditions. These high-risk pools, established under the health law, began signing up enrollees in August and September.

As of Nov. 1, Pennsylvania has enrolled 1,657 people — 1,000 more than any other state, according to figures released Friday by the Department of Health and Human Services. The Keystone state charges a $283 monthly premium — one of the lowest rates in the country. Pennsylvania is also the only state to charge the same rate regardless of age. Other states have higher rates for older people.

"Making it a little more affordable was in the thought process for us," said Melissa Fox, spokeswoman for the Pennsylvania Insurance Department.

Premiums vary in the program nationally to reflect partially differences in medical costs nationwide. Missouri, for example, has one of the highest monthly premiums – ranging from $423 to $972 a month. Only 101 Missouri residents have enrolled.

Many states were worried about not being able to meet the demand for coverage with limited federal funding. So 23 states and the District of Columbia opted to have HHS run the plan for them. HHS officials announced today that they will lower premiums by about 20 percent in 2011 and offer different cost/benefit options.  HHS asked the other states to consider lowering their rates as well.

“We expect enrollment to grow and escalate,” said Richard Popper, director for the Office of Insurance Programs in HHS’ Office of Consumer Information and Insurance Oversight.

“There’s no question that lower prices make some difference,” said Michael Keough, executive director of the North Carolina Health Insurance Risk Pool. North Carolina, where rates start at $183 a month, has enrolled 513 people, tied with California for fourth highest in the nation.

Overall, the new federal Pre-existing Condition Insurance Plan has attracted far fewer uninsured people than anyone expected. About 8,000 people have enrolled nationally even though the Congressional Budget Office has estimated that as many as 4 million uninsured Americans would be eligible and that 200,000 would be enrolled by 2013.

To be eligible for the new program, you must have been uninsured for at least six months and have a pre-existing condition. Most states require applicants to show proof that they've been rejected for coverage by a private insurer within the past six months or been denied coverage for certain benefits.

The federal government is subsidizing the program with $5 billion until 2014 when the program ends. At that time insurers will no longer be able to discriminate based on a person's health status.

Copyright 2023 Kaiser Health News. To see more, visit Kaiser Health News.

Phil Galewitz