Highlights of the Pre-Existing Condition Insurance Plan

Advocacy organization Keystone Progress held a virtual press conference Thursday with healthcare advocates, people with pre-existing conditions and beneficiaries of Pennsylvania Fair Care to highlight the Pre-Existing Condition Plan under the Affordable Care Act.

Pennsylvania Fair Care is a state funded insurance program administered by Highmark. It provides a health coverage option for Pennsylvanians who do not have health coverage due to a pre-existing condition. To qualify, a person has to have been without coverage for at least six months, and have a pre-existing condition.

The Affordable Care Act mandates that coverage needs to be made available to all eligible participants regardless of pre-existing conditions, and that the insurer must pay a minimum of 65 percent of all costs related to health services.

At the press conference, Healthcare Expert Antoinette Kraus of Pennsylvania Health Access Network talked about the many benefits of the insurance plan. Local residents with family members living with a pre-existing condition talked about how the Affordable Care Act no longer prohibits them from being denied coverage by private insurance companies because of a pre-existing condition. 

"If you have a pre-existing condition, or have been denied health coverage because of a health condition, Pennsylvania Fair Care will allow you to get the healthcare coverage you need," Kraus said. "We are glad to see the Affordable Care Act working here in Pennsylvania." 

Kraus also discussed enrollment in Pennsylvania, and the need for federally and state funded insurance options. She talked about how Fair Care is currently helping nearly 3,500 people manage their pre-existing conditions by providing affordable health care coverage. 

Barbara Stakes, a beneficiary of PA Fair Care, also spoke about how the program has helped her manage her life threatening condition.

"When I was kicked off of my husband's insurance plan, I needed to find a way of managing my condition," she said. "When private providers heard of it, they shut the door in my face or they asked me to pay a premium that would have been impossible. Fair Care has allowed to me to stay on my medication at a rate that I can afford."