By Amy Goldstein for the Washington Post

More Americans have been signing up for special health plans designed for people with medical problems that caused them to be spurned by the insurance industry, according to new government figures. But enrollment continues to lag significantly behind original predictions.

The number of people who have bought the plans, known as high-risk pools, has increased from slightly fewer than 8,000 nationwide as of early November to nearly 12,500 as of the beginning of this month, according to figures released Thursday by federal health officials.

Several months ago, the special insurance pools became one of the earliest facets of the new health-care law to take effect. They are intended as a temporary coping mechanism for people with medical conditions that traditional insurance companies do not want to cover. The program is temporary, because, starting in 2014, the law will forbid insurers to reject customers based on whether they are healthy or sick.

Last spring, the Medicaid program’s chief actuary forecast that 375,000 Americans would have joined new high-risk pools by the end of 2010.

Late last year, administration officials said the plans’ relative lack of popularity reflected early growing pains; they predicted that enrollment would grow swiftly as more people found out that they exist. Some state health officials and would-be customers said the more fundamental problem is that insurance for people with medical problems remains too expensive for some.

The law gave states the choice of starting an insurance plan for preexisting conditions or letting their residents enter a federal plan. Twenty-seven states have started their own. The new high-risk pool has attracted the greatest number of participants in Pennsylvania, where nearly 2,050 people have signed up, about 400 more than three months earlier.

In the Washington area, the District and Maryland have created their own pools, with 10 and 145 customers, respectively. Virginia, relying on the federal pool, has 204 participants.

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