health care
Premiums for pre-existing conditions could be costly
New federal website lets consumers compare prices
by RICARDO ALONSO-ZALDIVAR
updated 7/1/2010 12:15:21 PM
WASHINGTON — President Barack Obama's new health coverage for uninsured Americans with health problems won't be cheap — premiums averaging $300 to $600 a month in the largest states, according to a government website that went live Thursday.
From cheaper to most expensive, premiums will range from a $140 a month to as much as $900, Richard Popper, deputy director of a new insurance office at the federal Health and Human Services department, said Wednesday.
The range is so wide because premiums will be keyed to standard individual health insurance rates in each state, which can differ dramatically because of medical costs and the scope of coverage. Also, older people will pay more.
"There are going to be meaningful premiums that are going to be required to stay in this plan ... in the hundreds of dollars," said Popper, with the Office of Consumer Information and Insurance Oversight.
Estimates on HealthCare.gov show premiums for a 50-year-old in Florida will be $552 to $675 a month; in New York the cost will average from $400 to $600; in Texas it's $491 to $600, and in Pennsylvania $283 on average. In many states, consumers can start enrolling immediately.
Coverage for pre-existing conditions
Despite the cost, consumer advocates are urging uninsured people with health problems to sign up soon, because they cannot be turned away for medical reasons. Family members may be able to help with premiums, which are competitive with rates paid by people who buy their coverage directly from an insurance company.
The Pre-Existing Condition Insurance Plan will start taking applications in every state by the end of the month. Coverage will be available as early as August 1.
Consumers can go to the website to find out about the program, as well as other coverage options in their state, including government plans such as Medicaid, and private insurance. Starting this fall, the site will feature easy price and coverage comparisons among private plans. The new health care law called for the site, as a way to offer Americans one-stop shopping for coverage.
Twenty-nine states and Washington, D.C., will administer their own plans for people with pre-existing conditions. The federal government will run the program in the remaining 21 states.
The coverage is a stopgap for vulnerable people locked out of the private insurance market because of medical problems. It's intended to remain available until 2014, when core health care overhaul provisions take effect. At that time, insurers will be barred from turning away people in poor health, low- and middle-income households will get subsidized coverage, and most Americans will for the first time be required to carry health insurance.
To qualify for the pre-existing condition plan, people must be uninsured for at least six months and have been turned down for coverage by a private insurer because of a medical problem. U.S. citizens and legal residents are eligible.
Could funds run out?
The biggest question hanging over the program is whether the $5 billion allocated will be enough.
Millions of people meet the basic qualifications for coverage, and technical experts who advise Congress and the administration have warned the funds could be exhausted as early as the end of 2011.
HHS officials sidestepped questions about what would happen if the money runs out. One option is for the government to limit enrollment.
Popper estimated about 200,000 people would be enrolled in the program at any one time, but other HHS experts estimated that 375,000 would sign up this year, and the Congressional Budget Office says the total could reach 700,000 in 2013.
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