After three extensions, payers, patients say goodbye to high-risk pools

The Affordable Care Act's temporary insurance program for high-risk patients is finally ending as planned--after three extensions. The federally-run pre-existing condition insurance plan (PCIP) has stopped accepting new enrollment applications until further notice, according to its website.

Despite intentions to close PCIPs by the end of the year, since the reform law requires insurers accept all consumers regardless of health history, the Obama administration last month issued the third extension to the high-risk pool program. That delay allowed high-risk members to keep their current coverage through April 30, though they had to enroll in an exchange plan by April 15.

Some groups, including the American Cancer Society Cancer Action Network, have praised the delays, saying they helped consumers with cancer and heart disease to continually receive necessary medical care. But extensions to the PCIP made it challenging for insurers to calculate and set rates for the next open enrollment period, FierceHealthPayer previously reported.

Now extensions have run out for the high-risk pool program, which will likely close on April 30. Advocates have okayed the program's end because falling enrollment numbers since the end of January suggest more high-risk consumers have found coverage elsewhere, The Washington Post reported.

Because of the no insurer discrimination due to pre-existing conditions, some small companies are considering sending their most costly-to-ensure employees to the public exchanges. Meanwhile, insurers put certain pricey prescription drugs in specialty tiers that require members to pay more for them, causing some patient advocates to wonder whether they're trying to discourage consumers with pre-existing conditions from enrolling in their plans.

For more:
- here's the Post article
- check out the PCIP website