7/1/10 was a big day for implementation of some of the Patient Protection and Affordable Care Act’s most immediate provisions. The Department of Health and Human Services unveiled its new consumer Web portal, www.healthcare.gov, a number of states and the federal government began accepting applications for new programs to cover previously uninsured individuals with serious medical conditions, and a new tax on indoor tanning services went into effect.
The new consumer Web portal is geared toward individuals and small business owners to allow them to compare private health insurance option information, as well as obtain information and applications for public health coverage programs like CHIP and Medicaid on a state-by-state basis. It was required by the PPACA to serve as a central repository of information about coverage options and the rollout of the PPACA’s provisions until states begin operating their own health insurance exchanges with online components in 2014.
The portal is intended to be an evolving site, with information options being added between now and October 1. While the site does not currently contain a direct link to information about how to contact independent agents and brokers, representatives from the National Association of Health Underwriters have met with HHS and White House officials in the last few weeks to discuss adding this option in the near future.
One of the coverage information options included in the new web portal is the Pre-Existing Condition Insurance Plan (PCIP), the federal government’s new subsidized high-risk pool coverage option for previously uninsured individuals who have serious medical problems and previously had trouble accessing individual coverage. The PPACA gave states the option of operating their own such program by July or allowing for a federally administered plan in their state.
Twenty-nine states and the District of Columbia have opted to start their own plans, and 21 states will allow residents to enroll in the PCIP program. To be eligible for the coverage, people must have been denied coverage by a private insurer due to a preexisting condition, and they must have been uninsured for at least six months. The federal PCIP plan and many state plans began accepting applications for enrollment on 7/1/10. The hope is to actually begin covering individuals in August or, in some states, later this fall.
One of the major issues with the new program for uninsurable individuals is its cost. The PPACA appropriated $5 billion in funding for it over the next three years, and analysts at both the federal Centers for Medicare and Medicaid Services (CMS) and the Congressional Budget Office (CBO) have indicated that this amount will not be nearly sufficient to cover all eligible individuals across the nation, and that funding could run out as early as 2011. Most state programs have indicated their plans will cover individuals on a first-come first-served basis, so early applications are essential.
In addition, the premiums for coverage through this program, while subsidized to some degree, are still fairly expensive. Cost and benefit options will vary by state, but are expected to be in the range of $400-550 per month for single PPO coverage with a $1,500 deductible. As even Richard Popper, the former Maryland high-risk pool administrator and current HHS official operating the PCIP plan, noted, a “significant number” of people with preexisting conditions who are uninsured have limited income, and they will not be able to afford the premiums. He added, “But for those who can afford it this is going to be a great, great plan for them.”
Finally, in addition to the portal and the high-risk pool programs, a new 10% excise tax on indoor tanning services went into effect yesterday. This “sin tax,” which was added fairly late in the game to PPACA as a payment offset, has caught much of the American public by surprise. However, beginning yesterday, all indoor tanning salons must now levy this new tax directly upon their customers.