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Government extends deadline on insurance pools

The federal government Thursday gave about 100,000 people a one-month extension to stay in a high-risk insurance pool because of the botched roll-out of the federal health insurance websites. 

That Pre-Existing Condition Insurance Plan pool, which is run by the federal government, covers people private insurers wouldn't insure because of their often-serious medical conditions.

Those people will now have health coverage at least until the end of January, and thus another month to try to obtain coverage through the federally run HealthCare.gov or other state-run exchanges.

The delay reflects the fact that HealthCare.gov was essentially crippled for nearly two months by technical problems after its Oct. 1 launch, as were several other state-run insurance marketplaces, making it difficult if not impossible for some people who tried to shop for health plans to do so.

“Today, as part of our efforts to smooth the transition to the marketplaces for those seeking coverage that begins in January, we are taking steps to ensure that Americans enrolled in the federal PCIP insurance plan will not face a lapse when the new year begins," the Centers for Medicare and Medicaid Services, which runs the exchanges, said Thursday. 

"We are committed to providing consumers additional flexibilities while they evaluate and select a quality, affordable, health plan that meets their needs.”

Some states that run their own high-risk pools, and which hadn't already decided to extend them beyond 2013, are now considering a similar extension.

The high risk pools were created by the 2010 Affordable Care Act to ensure that people with pre-existing medical conditions would be able to have health coverage until at least 2014, when the law bars insurers from denying coverage to anyone for such reasons.

The federal PCIP was set to expire Jan. 1 because the government had expected that anyone who wanted to buy ACA-compliant insurance would be able to do so before that date from HealthCare.gov and the other exchanges.

But the technological problems of HealthCare.gov in particular have significantly hampered enrollment in Obamacare policies.

On Wednesday, officials said that nearly 365,000 people had enrolled in such plans through either the federal- or state-run health exchanges by Nov. 30, well below the 1.2 million enrollees that CMS chief Marilyn Tavenner had predicted would be signed up by that date in a memo she wrote in September.

In addition to the relatively low enrollment results, officials are facing another potentially serious problem. Up to 25 percent of the electronic enrollments made through the exchanges through the end of November, and up to 10 percent of enrollments thereafter, are believed to contain errors that could delay those people being formally enrolled in coverage for some length of time.

Those so-called "834 errors" are of particular concern because their number is likely to rise as enrollments rise over time.

Health insurance analyst Robert Laszewski said the new extension of the high-risk pool could mitigate some of that harm, but warned that the extension is coming late in the game.

"There is a big concern that with all of the problems accessing HeathCare.gov, as well as 834 errors as the government passes files to the insurance companies, that lots of people are going to fall through the cracks," said Laszewski, who operates Health Policy and Strategy Associates. "This extension would seem to provide an additional month for people in the high risk pools."

"However, this release talks about 'the option to remain' to remain in the pools. That suggests people will have a very limited amount to time to get this news and then have the responsibility to get signed up for the extra month," he said. "I expect this will lead to lots of confusion and anxiety for these people that will likely have to go through a last minute fire drill."

Senate Majority Leader Mitch McConnell, (R-Ky), said the extension was further proof of what Republicans argue is the folly of the health reform law.

"Despite the administration’s promises that Obamacare enrollment is on track, this announcement is a clear admission that Obamacare is failing Americans with pre-existing conditions who are losing the plans they already had," McConnell said. 

"How many extensions and waivers is it going to take for the administration to admit the consequences of Obamacare that are hitting millions of Americans they promised it would help?" 

HealthCare.gov's problems earlier lead officials to grant a one-week extension in the deadline to buy coverage through the exchanges that would begin Jan. 1. People now have until Dec. 23 to enroll in plans, and must begin paying premiums by Dec. 31 for that coverage to start New Year's Day.

That earlier extension came after a firestorm of criticism for the Obama administration for not having its federal exchange fixed in time to deal with the millions of people who began receiving cancellation notices from their private insurance carriers because their individual policies were not in compliance with the Affordable Care Act.