The ACA established the PCIP program to provide insurance to individuals with high-risk pre-existing conditions until 2014, when insurers will be prohibited from denying coverage to individuals with a pre-existing condition. The program is open to U.S. citizens and people who reside in the U.S. legally (regardless of income) who have been without insurance coverage for at least six months and who have a pre-existing condition or have been denied health insurance coverage because of a health condition. HHS Secretary Sebelius recently announced that almost 50,000 individuals currently are enrolled in the ACA PCIP program. The overall per-member claims costs have been 2.5 times higher than anticipated ($29,000) per year, which HHS suggests is a result of the individuals’ “critical need for treatment, combined with their lack of prior health coverage.”