The Affordable Care Act (ACA) mandated that every state create or maintain a Pre-Existing Condition Insurance Plan (or PCIP), which is essentially a state high risk pool to make health insurance available to people who have had a problem getting insurance due to a pre-existing condition. 

These PCIPs are temporary, and will provide health coverage to individuals with pre-existing conditions starting in July 2010, lasting until 2014.
 

The states were given the option, under the law, to establish their own state-run PCIP, or to defer to the federal government (HHS) to establish a PCIP. So far 27 states have set up state-run PCIP, and 23 states deferred to HHS-run PCIP.
 

Currently, 50,000 individuals have enrolled in PCIPs. CMS estimates 375,000 people may be eligible for coverage through them.