MRMIP Guaranteed Issue Pilot Program: Perspectives from the November 2005 Survey


Publication Date: April 2006

Publisher: California Managed Risk Medical Insurance Board

Author(s): California Managed Risk Medical Insurance Board

Research Area: Health


Coverage: California


In an effort to provide health coverage to uninsured, medically high-risk Californians who have exhausted all other options, the state established the Major Risk Medical Insurance Program (MRMIP) and began enrolling subscribers in 1991. With a $40 million annual spending cap over the last decade, the state-subsidized program could not meet the demand for coverage and a substantial waiting list for entry into the program resulted. To increase the program's capacity, the state legislature created the Guaranteed Issue Pilot Program, which placed a 36-month limit on MRMIP enrollment. Those required to leave are eligible to enroll with any health insurance carrier in California that participates in the individual policy market. In September 2003, more than 9,000 Californians left the MRMIP program under the 36-month rule and each was offered guaranteed private coverage. However, one in four chose not to accept it. This survey, funded by the California HealthCare Foundation, presents findings from a sample of 400 former subscribers -- including both those who accepted and declined the replacement coverage. It attempts to shed light on how these individuals made coverage choices and coped with their health care needs after leaving MRMIP. The report compares various characteristics within the group, including demographics, utilization of health care services, and factors influencing health coverage decisions. The survey findings are included in the 2006 Major Risk Medical Insurance Fact Book issued by the Managed Risk Medical Insurance Board. The resource is designed to inform the discussion about the future of the Guaranteed Issue Pilot Program, which will end in August 2007.