Pre-Existing Condition Insurance Plan for Affordable Health Care

Posted by Marla Roshkoff - 18 October, 2012


A main goal of health care reform is for all Americans to have access to affordable health coverage either through an employer or through a governmental health insurance exchange.

Health insurance exchanges are set to be operational January 1, 2014. At that time, employers will have to offer affordable health coverage or be subject to a penalty. See our prior articles on the Pay or Play Penalty.

The Affordable Care Act authorizes a government program called the Pre-Existing Condition Insurance Plan (PCIP) to bridge the gap between the passage of health care reform and the 2014 effective date of access to affordable health care. Each state and the District of Colombia has an operational PCIP. The PCIP program makes coverage available to US citizens and legal residents who have been denied coverage because of a pre-existing condition.

To be eligible for the program, an individual must have been uninsured for at least 6 months. The program covers many health benefits and is specifically designed for people who cannot obtain coverage due to their health conditions.

States' PCIP programs are administered by either the state or the federal government. The federal government administers the PCIP in 23 states and DC. 27 states have elected to run their own programs. Program requirements vary by state, as does the application process. For more information about eligibility and state operation, visit

Topics: Health Care Reform (ACA)

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