42,000 Working Poor to Lose Insurance and Another 460,000 Out of Luck in PA

Expiration date for adultBasic?

Funding source needed soon for subsidized state-run health insurance for the working poor

By Bill Toland, Pittsburgh Post-Gazette –

All last week, at vigils in Pittsburgh and street performances in Philadelphia, small groups of protesters all but begged incoming Gov. Tom Corbett to make his No. 1 priority the continued funding of adultBasic, the subsidized, state-run health insurance program for the working poor.

More than 41,000 are enrolled in the program, with hundreds of thousands more on the waiting list. The insurance is subsidized through tobacco settlement money and, more recently, through an agreement with the state’s Blue Cross-Blue Shield insurers. But that agreement is set to expire, and health care advocates say consequences would be dire if a new funding source isn’t found, or the Blues funding isn’t renewed.

So far, no renewal.

“I think this is hard for a new governor to come in and have to deal with this problem,” said Sharon Ward, director of the Pennsylvania Budget and Policy Center, a Harrisburg research and think tank that leans to the left.

“We don’t want to have another Valentine’s Day massacre,” she said, alluding to the possible date when adultBasic might face a cash shortage.

In 2005 the Blues, which are nonprofit health insurers, signed on to the Community Health Reinvestment Agreement, a pact negotiated with Gov. Ed Rendell. The agreement funded a variety of state health programs, including adultBasic. The agreement included an expiration date — Dec. 31, 2010 — but the Blues have agreed to continue funding their share of the program into next year, to the tune of $51 million.

However, AdultBasic advocates say that money might not last through the winter, given that the governor’s office has calculated the program will need at least $77 million. The money pays for health insurance for people living at, or below, 200 percent of the poverty line.

“The negotiated settlement just wasn’t sufficient to meet the goal,” said Ms. Ward, and Democratic legislative efforts to extend the agreement statutorily have gained little support.

The Blues, including Pittsburgh’s Highmark and Philadelphia’s Independence Blue Cross, have said throughout the year that they don’t have financial flexibility to commit to another six-year pact, and that the state of the economy — and especially the health care industry — is much different now than it was in 2005.

That hasn’t stopped some lawmakers from pushing for an extension, though. Earlier this month, state Rep. Tony DeLuca, D-Penn Hills, sent a letter to Mr. Corbett, asking him to “address Pennsylvania’s looming health-care insurance crisis.”

“It is imperative that people who are enrolled in the adultBasic health-care plan continue being covered,” Mr. DeLuca said.

The Pennsylvania Budget and Policy Center, the Pennsylvania Health Access Network and other signees similarly sent a letter to the governor-elect last week: “You have said your goal is to preserve insurance for 90 percent of Pennsylvanians who have it. … We urge you to keep this pledge and take action to preserve insurance coverage for adultBasic participants.”

A phone call to Mr. Corbett’s spokesman was not returned. Many state politicians spent the weekend in New York City for the Pennsylvania Society party, an annual meet-up of lobbyists, business leaders and elected officials.

If the program money becomes in real jeopardy of running out, adultBasic subscribers — most of whom make between $10,000 and $20,000 a year — would receive a notice in the mail, said Beth Heeb, executive director of the Consumer Health Coalition.

Legislators, the governor’s office and the state Department of Insurance continue to search for alternative avenues of funding in the event that the community health act isn’t extended, but the Insurance Department is taking the prospect of a shutdown seriously enough to post the following warning on its webpage:

“ALERT: adultBasic coverage may expire February 2011. The adultBasic insurance program does not have funding to provide coverage to enrollees beyond February 28, 2011. The program had hoped to secure enough funding to provide coverage through June 2011. That has not occurred. It is possible that additional funding will become available, but none has been identified.”

See also “Thousands Losing Health Coverage Jan. 1.”