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Pa. insurance dept. to feds: Fair Care suspension sudden, troubling

By - Last modified: February 21, 2013 at 10:14 AM

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Pennsylvania's Insurance Department is asking the U.S. Department of Health and Human Services to reconsider its recent decision to suspend enrollment in state-based pre-existing condition insurance plans by March 2.

"PA Fair Care has been a very successful program that currently serves 6,779 Pennsylvanians," PID commissioner Michael Consedine wrote in a Feb. 20 letter to HHS. The temporary program was instituted in 2010 as part of the Patient Protection and Affordable Care Act and was designed to provide affordable coverage until enrollees could get access to insurance under the new federally facilitated health insurance marketplace in January 2014.

"Last week, we had conversations with the federal government leading us to believe they would not institute an enrollment cap until late fall, effectively maintaining an affordable option for these individuals until exchange coverage becomes available," Consedine said in a news release. "CMS's announcement to suspend enrollments the day after that conversation not only took us by surprise, but raised significant concerns over the number of individuals that may be left without a coverage option over the next 10 months."

The program, which had both federal and state versions, had $5 billion in funding, and a posting on healthcare.gov says the suspension "will help ensure that funds are available through 2013 to continuously cover people currently enrolled."

A federal report said the funding was initially projected to run out in 2012, but the program drew fewer "but much more expensive" enrollees than expected. The program also has increased out-of-pocket limits for enrollees, to $6,250 per year for covered, in-network services.

Heather Stauffer

Heather Stauffer

Heather Stauffer covers Lancaster County, nonprofits, education and health care. Have a tip or question for her? Email her at heathers@cpbj.com. Follow her on Twitter, @StaufferCPBJ.

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