Coverage for people who’ve had trouble buying health insurance

Federal health officials are touting a new plan that will give people with serious medical conditions a chance to buy health insurance. Some benefit experts worry the government hasn’t set aside enough money for all the people who will want to enroll.

Federal health officials are touting a new plan that will give people with serious medical conditions a chance to buy health insurance. Some benefit experts worry the government hasn’t set aside enough money for all the people who will want to enroll.

Right now, people with chronic problems such as diabetes or arthritis are often rejected when they apply for health insurance on their own.

The federal health law created temporary “pre-existing condition” plans to give those people a place to get coverage.

Pennsylvania state officials say they have enough money to enroll about 5,600 people between now and 2014.

U.S. Department of Health and Human Services official Richard Popper says HHS will work to stretch the money.

Popper: If we have that situation where we have strong demand in one state and not as strong demand in another state, the secretary of HHS has the authority, after a year or two, to reallocate the funding to those states that have stronger demand, and from those state where the demand is not as great.

Federal subsidies keep the plan costs lower than usual, but Popper says the monthly premiums may still be unaffordable.

In Delaware, a 50-year-old could pay about $525 a month. In Pennsylvania an average premium cost will be about $280 a month.

Richard Weishaupt is a health law attorney with Community Legal Services in Philadelphia. He says that’s a pretty good bargain for people who’ve been locked out of the health insurance market.

The new plans are only for people who’ve been uninsured for six months or more.

Coverage varies state to state, but Richard Popper says people with cancer, AIDS, even obesity or high blood pressure may qualify.

Popper: The way, probably, most people will qualify, will be if they apply for individual coverage in that state and are rejected because of their pre-existing condition, or if they apply for coverage and the carrier said ‘We’ll offer you coverage but we’re not going to cover your pre-existing condition, we’re going to exclude it.’

Weishaupt says it’s no surprise that Pennsylvania’s $160-million budget won’t go far.

Weishaupt: Especially when you consider that these folks are high risk, they have medical conditions that are expensive to treat.

Delaware residents can log onto healthcare.gov to find out if they qualify for the new health insurance plan. While the federal government will run the plan for Delaware residents, Pennsylvania and New Jersey will run their own plans in-state.