Wednesday, February 23, 2011

In Pa., Low-Income Adults Soon May Be Uninsured #p2

When Paula Michele Boyle first received the letter earlier this month explaining that her health insurance coverage was being terminated, she took it personally, thinking maybe the insurer had discovered something in her history to make her ineligible. But then the Philadelphia resident read on and realized that it wasn't just her — the entire program, Pennsylvania's state-funded health plan for low-income adults, was about to be canceled.

For Boyle and her husband, Tom, both self-employed cancer survivors who need regular medical care, the news has been unnerving.

"We were in shock over this," Boyle says. "What are we going to do now? We need doctor visits and testing."

Nearly 42,000 people who participate in the program have received similar notices. Another 494,787 people had been on the waiting list, hoping to get such coverage.

Budget Shortfalls Hit Health Coverage Program

Pennsylvania's adultBasic insurance was created in 2001 and is one of only a handful of entirely state-funded health plans to provide coverage to low-income adults who do not qualify for Medicaid, the joint federal-state health insurance for the poor. Such individuals will either be eligible for subsidized private coverage or be covered by an expansion of Medicaid under the new federal health law, but those provisions do not kick in until 2014.

AdultBasic is paid for through a combination of money from the state's tobacco settlement and donations from the state's four Blue Cross and Blue Shield insurance companies. It cost $166 million in 2010. With the tobacco money dwindling and the cost of health care increasing, the state has not identified other funds to make up the difference, although officials are still searching.

The deal with the insurers was set to expire this past December, but they agreed to contribute $51 million to extend the program. Shortly after taking office in January, however, Gov. Tom Corbett, a Republican, announced that the program was out of money and coverage for all participants would end Feb. 28.

The recession has left many states with severe budget shortfalls scrambling to find spending cuts. Many are looking at their health care expenses and have asked federal officials for leeway so they can trim their expensive Medicaid programs. But a requirement in the new health law limits states' efforts to reduce the number of people on Medicaid. States can, however, make cuts to special state programs, such as adultBasic, that don't receive federal assistance.

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