Bold New Insurance Plan Launches

Health Coverage Now Available for Americans without Insurance Due to Pre-Existing Conditions Such as Lupus

Thursday, July 1, 2010

Washington, D.C. — With persistence from organizations such as the Lupus Research Institute (LRI) National Coalition and others, people who couldn’t get health insurance because of a pre-existing condition such as lupus now have an option to secure coverage, announced U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius.

Beginning July 1st, the “Affordable Care Act Program” provides temporary coverage for U.S. citizens (or legal residents) who have been uninsured for at least six months and couldn’t get coverage because of a health condition. Either the state or HHS itself will run the actual insurance plans, called “Pre-existing Condition Insurance Plans (PCIP).

“For too long, Americans with pre-existing conditions have been locked out of our health insurance market,” said Secretary Sebelius in an HHS statement.

“What a game-changing moment this is for the 1.5 million Americans with lupus, so many of whom were denied health insurance because of their pre-existing condition,” said LRI President Margaret G. Dowd. “The LRI National Coalition of state and local lupus groups, along with other allies, has worked with intelligence and determination in the nation’s capital to get this injustice reversed.”

How the Plan Works

The program will be in effect until 2014, when insurers will be banned from discriminating against Americans with pre-existing health conditions altogether—and more affordable private insurance options will be made available through new competitive “exchanges.”

The PCIP, which doesn’t base eligibility on income and doesn’t charge higher premiums because of a health problem, covers primary and specialty care, hospital care, prescription drugs, and more.

As with the Children’s Health Insurance Program (CHIP), the PCIP for adults gives states flexibility in running their individual program—as long as basic requirements are met.

For more information on applying for PCIP, visit the consumer website, www.HealthCare.gov, a new information tool that enables users to compare affordable public and private health care coverage options.

It’s a tool to “help consumers take control of their health care and make the choices that are right for them, by putting the power of information at their fingertips,” said Secretary Sebelius.

The 29 states (plus D.C.) that will operate their own plans:

1. Alaska
2. Arkansas
3. California
4. Colorado
5. Connecticut
6. District of Columbia
7. Illinois
8. Iowa
9. Kansas
10. Maine
11. Maryland
12. Michigan
13. Missouri
14. Montana
15. New Hampshire
16. New Jersey
17. New Mexico
18. New York
19. North Carolina
20. Ohio
21. Oklahoma
22. Oregon
23. Pennsylvania
24. Rhode Island
25. South Dakota
26. Utah
27. Vermont
28. Washington State
29. West Virginia
30. Wisconsin

The 21 states for which HHS will run their plan:

1. Alabama
2. Arizona
3. Delaware
4. Florida
5. Georgia
6. Hawaii
7. Idaho
8. Indiana
9. Kentucky
10. Louisiana
11. Massachusetts
12. Minnesota
13. Mississippi
14. Nebraska
15. Nevada
16. North Dakota
17. South Carolina
18. Tennessee
19. Texas
20. Virginia
21. Wyoming