Monday, January 14, 2013

PCIP Turnabout

Over the years, we've lamented the poor participation rates and stupid eligibility rules for the Pre-existing Condition Insurance Plan, aka PCIP. Now comes word that HHS Secretary Shecantbeserious is in a spitting contest with Ohio Insurance Commish Taylor. Perhaps the most interesting part is whose side each of these fine ladies are on:

"[Ms Shecantbeserious] has ordered 14 people to be dropped from Ohio’s temporary high-risk pool for the chronically uninsured ... after determining they had previous coverage that disqualified them from enrolling."

Yup, one of those stupid eligibility rules is that one must not have had "creditable" insurance coverage for the preceding six-months.  A while back, we investigated just what comprised "creditable" coverage, and were left pretty confused. In theory, only major medical plans counted; so-called "mini-med" (or limited benefit) plans did not.

But there's no actual verbiage which specifies this, it's all inference. It seems that Ms Taylor's position is that "lousy" coverage is, in fact, not creditable, and therefore passes the PCIP "smell test." It's an interesting theory, but one which is open to lots of interpretation. On the other hand, Ms Shecantbeserious contends that the quality of the previous insurance (if any) is immaterial, it's enough that the person had any coverage.

Medical Mutual, the carrier tasked with implementing the Buckeye State's PCIP program, has gone to court asking for clarification. Of course, it's most likely a moot point: by the time a decision is reached, The ObamaTax will be in full implementation mode and the plan itself will be a memory.

Too bad, really, coulda been interesting.

[Hat Tip: FoIB Patrick P]

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