Low visibility hampers federal health

Few Nebraskans have enrolled in the temporary federal health insurance program for people with pre-existing conditions, either because they don't know it exists or because of strict limits on who qualifies.

In an effort to boost participation, federal officials recently renewed efforts to promote the program while lowering costs and easing hurdles.

From its start in July 2010 through March, 91 of an estimated 27,000 potential Nebraska qualifiers enrolled in the Pre-Existing Condition Insurance Plan, which was created as an interim measure until the bulk of Affordable Care Act programs begin in 2014.

Advocates say qualified Nebraska residents could save thousands of dollars over what they would pay to join a longstanding state program for those who have trouble getting health insurance.

But anyone already enrolled with the State Comprehensive Health Insurance Pool, or CHIP, cannot qualify for the PCIP, because the federal program is only for people who have not had health insurance coverage over the previous six months.

Sign up for the state program, and you cannot sign up for PCIP without going uncovered for six months.

"The requirement that you be without insurance for six months," said Mark Intermill, director of advocacy at Nebraska AARP, "that trips up a lot of people."

Roughly 5,000 Nebraskans participate in the state program, he said.

"It would be a real benefit if those individuals could switch over."

As of July 1, PCIP premiums in a number of states, including Nebraska, will decrease.

For a 50-year-old non-smoker, Intermill said, PCIP monthly premiums will be about $300 in Nebraska, compared with $763 for the state program. Potential savings amount to more than $5,000 a year for nearly three years.

After 2014, a person could not be denied health insurance because of pre-existing conditions, and there could be tax credits to reduce premiums, although the processes involved are still being determined.

"How those will work in the state," Intermill said, "we don't have a clear picture of that yet."

Until recently, those enrolling with PCIP also had to produce a recent letter from a health insurer denying them coverage. Now, they need only produce a letter from their doctor attesting to their medical condition. They still need to have been uninsured for six months and they also must be legal residents.

Natalie Duy, a regional Medicare official working to promote the PCIP, said Nebraska was one of 23 states that opted to let the federal government operate the interim program rather that do it themselves.

States that did their own programs tended to promote them better, she said. That's why the federal government is promoting its program now, she said.

Another benefit of the federal program, she said, is that all benefits become available upon enrollment. With the state program, she said, some benefits do not become available for the first six months.