Today is D Day for close to 42,000 working Pennsylvanians in terms of their health insurance. Today adultBasic, a state program designed to provide health insurance for residents ages 19 through 64 who meet income-eligibility requirements, has officially run out of money.
More than 1,700 Delaware County residents who rely on adultBasic, are without health care coverage and more than 17,400 Delaware County residents who were on the waiting list for the low-cost health insurance have now also been set adrift.
AdultBasic’s death knell has been sounding almost from the time of its inception.
The health insurance program for the working poor was the result of Pennsylvania’s Health Investment Insurance Act 77, signed into law in June 2001. Coverage began in July 2002 and by January 2003, a waiting list had formed for the health insurance program that had a monthly premium of $36 per person. The last waiting list included 478,735 Pennsylvanians.
The need for adultBasic is consistent with a need that has been growing nationwide for decades since health insurance became big business instead of a safety net for patients facing overwhelming medical bills. Medical bills are now the second leading cause of bankruptcy in the United States. By early 2010, close to 59 million Americans were without health care coverage.
All of us pay for them either through tax-funded Medical Assistance, state reimbursements to hospitals that provide uncompensated emergency room care or exorbitant private health insurance premiums.
Last March President Barack Obama accomplished a feat none of his predecessors were able to achieve. He passed the Patient Protection and Affordable Care Act of 2010 aimed at getting health coverage to at least 32 million of the uninsured.
Despite the bipartisan efforts that went into formulating the landmark legislation, Obama’s political opponents wasted no time in demonizing health care reform, calling the president – heaven forbid – a socialist for his efforts to address the national health care crisis.
The irony is, some health care reform critics who cry “socialism” are recipients of Medicare and Medicaid, government-run health care insurance programs. Many of them are legislators who don’t hesitate to avail themselves of the Federal Employees Health Benefits Program, more than 70 percent of which is taxpayer-funded.
One early opponent of the Patient Protection and Affordable Care Act of 2010 which, if implemented could eventually eliminate the need for such programs as adultBasic, is newly installed Republican Gov. Tom Corbett.
In his previous role as attorney general, Corbett joined a lawsuit challenging the constitutionality of the patient care act that requires all Americans to purchase health insurance or pay an annual tax penalty. While Corbett has been vocal in his opposition to federal legislation designed to expand health care for Americans, he has had little to offer the working poor in Pennsylvania now left without health insurance because of the end of adultBasic.
The adultBasic program was built on the investment of the state’s tobacco settlement, from which Pennsylvania officials expected to receive about $11 billion or about $400 million annually, over 25 years. It had also been funded by the community health reinvestment agreement from the four state Blue Cross/Blue Shield plans that began in 2005. The insurance companies had committed 1.6 percent of their health care premiums and an additional 1 percent of their Medicare and Medicaid premiums to the program, with some exceptions. The agreement expired Dec. 31, 2010.
Corbett’s solution is to direct former adultBasic subscribers to another Blue Cross program, Special Care, that will cost as much as 400 percent higher than adultBasic premiums. Created by Blue Cross in 1992, Special Care offers fewer services than adultBasic and, in fact, was the reason many Pennsylvanians turned to adultBasic. For people with chronic conditions, it is basically useless.
A provision of the health care reform act that would prohibit health insurance companies from denying insurance to Americans with pre-existing conditions and therefore help alleviate the need for adultBasic, is not due to go into effect until 2014. Until then, Pennsylvanians with pre-existing conditions who have been denied health care coverage by insurance companies and have been without insurance for at least six months are eligible for PA Fair Care, which has a monthly premium of $283 plus co-pays and co-insurance. It is even more financially prohibitive than Special Care.
One of the most disheartening remarks to emerge from the Corbett administration in reference to the adultBasic dilemma came last week from the governor’s spokesman, Kevin Harley. When questioned by an Associated Press reporter about the fate of adultBasic, Harley immediately turned the conversation political.
“It’s unfortunate that Gov. Rendell never lived up to his commitment. The fact is, it’s not sustainable and there’s no money in the budget for it,” said Harley.
The fact is, Rendell offered a temporary solution to the byproduct of a long-term national epidemic, that is, a very sick health care delivery system. So far, Mr. Harley’s boss has brought nothing constructive to the table. On the contrary, his effort to undermine health care reform is only making the situation worse.