Adultbasic Insurance For Working Poor Set To Expire

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Pittsburgh Post-Gazette (Pennsylvania)
January 12, 2011

With adultBasic, the low-cost health insurance program for Pennsylvania's working poor, set to run out of money soon, it appears the program's 41,000 subscribers will have to make alternative arrangements for health coverage -- or go without it -- starting Feb. 28.

One option: Everyone currently on adultBasic who continues to meet the program's income eligibility requirements can slide over to another low-cost health insurance plan, called Special Care, operated by the state's Blue Cross-Blue Shield health insurers.

One problem: The Special Care program, with premiums starting at $80 a month, is more expensive than the adultBasic plan, which offered coverage at $36 a month.

They've made these arrangements, said Kevin Harley, spokesman for Republican governor-elect Tom Corbett, because outgoing Democratic Gov. Ed Rendell failed to come up with the cash to allow adultBasic to operate through the summer, or longer.

"There's no funding for it. If there's no funding for it, the program doesn't exist," Mr. Harley said. "Don't make promises you can't keep."

He also blamed the governor for putting off the problem and failing to formally notify current adultBasic enrollees that the program was set to expire. It's an accusation that Rendell spokesman Gary Tuma calls "entirely inaccurate."

For one thing, the state Insurance Department posted a warning on its webpage more than a month ago that says, "ALERT: adultBasic coverage may expire February 2011. The adultBasic insurance program does not have funding to provide coverage to enrollees beyond February 28, 2011 .... If no further funding is identified, coverage termination notices will be sent out in January 2011."

Written notification hasn't been sent out until now, Mr. Tuma said, because it would have been premature to do so.

He also said Mr. Rendell called a December meeting with Mr. Corbett and others to discuss budget issues, one of which was the impending expiration of adultBasic funding.

"We told them, 'We'll do whatever you want us to do here. It's a problem you'll have to deal with,'" Mr. Tuma said. "Instead we get Kevin Harley saying that Ed Rendell didn't want to give the bad news, and he dumped it on Tom Corbett.

"It is entirely inaccurate."

AdultBasic is a health plan largely for the working poor, separate from Medicare and Medicaid. It is, and was, funded with tobacco settlement money and through the Community Health Reinvestment program, a pot of money funded by the Blues affiliates in Pennsylvania as part of a six-year deal with the state and Mr. Rendell.

That funding deal expired Dec. 31.

That the governor-elect's spokesman is celebrating the Special Care solution also rubs Mr. Tuma the wrong way.

"He portrays this [like] the incoming administration has come up with a solution. This is not a solution at all. Special Care has existed since 1992," he said.

One health care advocate panned the solution.

"The Special Care program offers completely inadequate health insurance," said Laval Miller-Wilson, executive director of the Pennsylvania Health Law Project, in a statement. It "covers only catastrophic care in the hospital and limited coverage for outpatient care, [and] is useless for anyone with a chronic condition and may be worse than no insurance because it gives a false sense of security."

Mr. Harley said last-ditch arrangements were necessary because the Rendell administration reneged on a "deal" to provide $56 million to complement an additional six months of Blue Cross-Blue Shield money, to allow the program to operate through the 2010-11 budget year.

"He can find money for other projects out of thin air, [such as] $45 million for the Port Authority," but not for adultBasic.

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