A stop-gap federal program for the uninsured has helped nearly 50,000 people with pre-existing conditions obtain health coverage, according to a new government report.

Established by the Affordable Care Act, the $5 billion program was set up to help people who couldn't otherwise get medical coverage. It expires in 2014, when the law mandates that insurers no longer reject people with pre-existing conditions, whose care can be far more costly than average.

"This is a safety net, a kind of bridge coverage," explained Jean P. Hall, an associate research professor at the University of Kansas who studies health care reform.

In its annual report on the program, the Pre-existing Condition Insurance Plan (PCIP), the government said it has "changed tens of thousands of lives and, in many cases, literally has saved lives." It cited several examples, including:

• A Texas man, James Howard, who hadn't been able to obtain affordable medical insurance coverage to treat his brain cancer, which required drugs that cost up to $10,000 a week, but was able to get insurance through PCIP. "Without the insurance plan I'm on, I wouldn't be alive today," Howard said in the report. "I'm living testimony as to how this has helped out in my life."
• A Virginia woman, Deborah "Jo" Cunningham, who could not get an affordable policy because of a pre-existing medical condition. She signed up for PCIP and, a short time later, was diagnosed with thyroid cancer. The report credited the insurance coverage with helping her overcome the cancer and avoid medical bills of more than $120,000.

Despite such successes, though, the roughly 50,000 people now covered are far fewer than the 375,000 that Medicare had estimated would take part.

PCIP programs are available in all states and the District of Columbia. Currently, 27 states run the programs with federal funding, sometimes in conjunction with programs they already had in existence -- known as high-risk pools -- to provide coverage to those with pre-existing conditions. The federal government offers coverage directly in all other locales.

To sign up for PCIP, however, people must have gone without insurance for at least six months. Those who remain in existing state high-risk plans are thus ineligible for PCIP, even if a state plan is more expensive and offers less coverage than PCIP would.

Also, the cost of PCIP coverage may have kept some otherwise eligible people from participating, although the federal government recently lowered the premiums in an effort to attract more users. In Tennessee, for example, the lowest monthly premium under the PCIP program is $425 for people 55 and older. It's $470 in Georgia and $424 in North Dakota.

Nonetheless, "what we've heard is that it's been a godsend for the people who are enrolled," Hall said. "It's made a huge difference."

In releasing the annual report late last month, Health and Human Services Secretary Kathleen Sebelius touted the benefits of the program, noting that "for too long, Americans with pre-existing conditions were locked out of the health care system and their health suffered." Now, with PCIP, she said, "our most vulnerable Americans across the country have the care they need."

That's come with higher-than-expected costs, however. The report estimated the average cost per PCIP enrollee would be $28,994 in 2012. Overall, costs have been 2.5 times the initial estimated rate, according to the report.

In recent weeks the government has also released data on other aspects of the health reform law, reporting that:

• Lifting of lifetime limits on health insurance coverage has benefited more than 105 million Americans. Previously, people with cancer or other serious long-term illnesses risked having their coverage cut off if their medical care reached their policy's maximum dollar limit.
• Allowing young people to stay on their parents' insurance plans until they're 26 has helped 1.3 million minority youths, including 736,000 Latinos, 410, 000 blacks, 97,000 Asian Americans and 29,000 American Indian/Alaska Natives.
• Starting to fill the so-called "donut hole" in Medicare prescription drug coverage has so far benefited about 5.1 million seniors and people with disabilities, saving more than $3.2 billion total on prescription drugs. The savings stem from such things as a one-time $250 rebate check to seniors who hit the donut hole in 2010 and a 50 percent discount on covered brand-name drugs in the donut hole in 2011.