[Congressional Record (Bound Edition), Volume 158 (2012), Part 10]
[Extensions of Remarks]
[Page 13409]
[From the U.S. Government Publishing Office, www.gpo.gov]




            ON INTRODUCING THE PCIP IMPROVEMENT ACT OF 2012

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                         HON. ALCEE L. HASTINGS

                               of florida

                    in the house of representatives

                        Thursday, August 2, 2012

  Mr. HASTINGS of Florida. Mr. Speaker, I rise today to introduce the 
PCIP Improvement Act of 2012, a bill that will make much needed 
improvements to the Pre-Existing Condition Insurance Plan (PCIP) 
program, created by the Affordable Care Act (ACA).
  As you know, the ACA prohibits insurance companies from refusing to 
sell coverage or renew policies because of a person's pre-existing 
condition. While the provision already affects children up to 19 years 
of age, it will only apply to adults in January 2014. In the meantime, 
adults with a pre-existing condition can get coverage through the PCIP 
program, a temporary high-risk pool which has helped over 50,000 
previously uninsured individuals get coverage.
  While I have always been a strong supporter of this important 
program, I believe that some improvements need to be made in order to 
make it a success. Indeed, enrollment has been significantly lower than 
initial projections, which varied from 200,000 to 375,000. One of the 
biggest obstacles for enrollment in the program is a Congressional 
mandate requiring that individuals applying for PCIP coverage have not 
had creditable insurance coverage during the 6 months prior to the date 
they apply to the program. Since the program's inception in July 2010, 
69 percent of applications have been denied because individuals had 
creditable coverage within 6 months of applying.
  While well-intentioned, this wait period has shown adverse effects by 
incentivizing people with pre-existing conditions to go uninsured for 6 
months to qualify for the program. Individuals who lost their health 
insurance through no fault of their own and can no longer find coverage 
must wait 6 months to apply, thus exposing themselves to high out-of-
pocket medical costs and unnecessary health risks. Unfortunately, 
because they go without insurance for such an extended period of time, 
they enter the program with a need for immediate care and cost more to 
the program.
  Furthermore, considering mini medical plans as creditable coverage 
also encourages individuals to go with absolutely no coverage for 6 
months in order to apply to PCIP. Mini medical plans are basic plans 
that may pay for portions of a doctor's visit or prescription drug, but 
do not provide catastrophic coverage or enough benefits for people with 
pre-existing conditions. Individuals who choose to obtain such a plan 
within 6 months of applying for PCIP to limit their medical liabilities 
will no longer be eligible for the program.
  Such a misfortune happened to one of my constituents who lost his 
health insurance when he lost his job and has been denied coverage 
because of a pre-existing condition since then. In June 2010, he 
received limited coverage through a mini medical plan that did not 
cover his pre-existing condition. When he applied to PCIP in September 
2011, his application was denied because he had such plan within 6 
months of applying. The only way for him to qualify was to go 
completely uninsured for 6 months. I cannot, in good conscience, advise 
my constituents in need of immediate care to wait 6 months to seek 
medical coverage.
  Mr. Speaker, this legislation will address these serious issues by 
eliminating the 6-month wait period and excluding mini medical plans 
from creditable coverage. My bill will bring us on step closer to 
ensuring accessible, affordable, and quality health care for all 
Americans. I urge my colleagues to help make PCIP a more successful 
program by supporting this important legislation.

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