California PCIP Substantially Lowering Enrollment Numbers

California PCIP has lowered the number of available slots due to excessive utilization of benefits. The CA PCIP will cap enrollments at 6,800 down from the originally projected 24,100 by 72%.

CA PCIP was granted funding in 2010 to establish the risk program run by the MRMIB (Major Risk Medical Insurance Board) which also runs the MRMIP -- California's state risk program.

The funding was intended to provide health insurance coverage for those who were uninsurable and had not had coverage in more than six months prior to applying. Original utilization projections were between $1000 and $1,100 Per Month Per Member. Actual utilization has been determined at $3,100 Per Month Per Member, over three times the projected usage. (see MRMIB November PCIP Agenda Item)

CA PCIP is currently seeking an additional $500,000,000 of funding to increase the available member slots to 11,247, still over 50% below the original projection of 24,100 member slots. If such additional funding is not received from the Obama administration, the CA PCIP will remain capped at 6,800.

CA PCIP currently has over 5,000 people enrolled in the plan. Once the plan hits the maximum enrollment of 6,800 (this could happen very soon) it will close to new enrollments. The process for future applications after the pool is full have not been disclosed. It may close or there may be a waiting list.



  1. I'm really surprised by these developments. I never would have thought enrollment would decrease and by such a large margin.


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