Basic Health Care Bankrupt

Pa.'s adultBasic health insurance runs out of funds, shuts down

March 01, 2011|By Don Sapatkin, Inquirer Staff Writer


Tens of thousands of Pennsylvanians woke up without health coverage Tuesday morning, as the state's subsidized insurance program for working people ran out of money and moves to save it failed to gain traction.

"The fiscal reality is there is no money in the budget," said Kevin Harley, a spokesman for Gov. Corbett, who is confronting a $4 billion deficit.

The loss of the program – three years before the federal health overhaul that would cover most of its subscribers is due to kick in – meant a stark choice for the husband-and-wife owners of Charmingly Linda's Quality Consignments in Frazer.

"We can't afford for both of us to be insured," Linda G. Nahrgang said Monday night. She's 57 and he's 44, she said, so she will get the most bare-bones insurance possible. He will go without.

AdultBasic, as the state program is known, ended with about 40,764 subscribers – and a waiting list that has mushroomed during the economic downturn and totaled 505,624 in February. While coverage was basic, the premiums were an unusually low $36 a month.

The most likely alternatives for most subscribers, and the one suggested by the Corbett administration, are the unrelated low-income Special Care policies that are offered by the state's four Blue Cross Blue Shield plans. Insurance for a single adult costs about $148 a month, and is more basic than adultBasic – with a limit of four doctor visits a year, for example. (Neither policy covered prescriptions.)

But former subscribers to adultBasic, which was operated by the Blues under contract with the state, are being accepted with preexisting conditions into Special Care through May 2 – an extension that Corbett requested of the Blues. Many would have difficulty finding insurance of any kind on the private market.

More than 14,000 Special Care applications have been requested and about 3,900 returned for processing so far, said Rosanne Placey, a state Insurance Department spokeswoman.

Some people have suggested that up to half of adultBasic subscribers might be able to get coverage under Medicaid, the state-federal program for the poor and disabled, but Placey said that subscribers had been automatically evaluated upon annual renewals and any who were eligible for Medicaid were transferred.