California

Health Care Sticker Shock In California: Claims Data For ObamaCare's High Risk Pool Program Comes in Three Times Higher Than Expected

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Heard it through the grapevine.

Before ObamaCare's state-based high risk pool program—the pre-existing condition insurance plan (PCIP)—went into effect, critics (including me) warned that enrollment in the program would run high and that as a result the program would go overbudget.

In California, at least, it turns out that prediction was half wrong. Enrollment in the program is much lower than expected. But program administrators are now worried it might go over budget anyway. Via California Healthline:

The threshold for the number of Californians who might participate in PCIP was estimated at about 23,000 people. Since a few more than 5,000 people signed up in that first year — and new enrollees came on board at a rate of roughly 500 a month — it seemed that the program was financially stable and able to take on more participants.

But after the first year, state officials got their first real claims data to test that estimate, and the amount required by recipients was much higher than expected. That 23,000-person threshold estimate was reduced to 6,800 Californians.

That means (given current enrollment of 5,290 including last month's bump of 726 new subscribers), there's now only room for a little more than 1,500 new enrollees (which is about two months' worth of enrollees, given October's bump of 726 new subscribers).

Unless the federal government pumps more money into the program.

Enrollment figures in the programs are well below expectations all over the country, yet California isn't the only state that's managed to have budget troubles. In December of last year, The Washington Post reported that New Hampshire's program had blown through twice the $650,000 in federal funding it had been allotted, despite enrolling just 80 people.