DN Editorial: Health care: Bye-bye, safety net

Posted: December 13, 2010

LAST WEEK, MORE than 200 Pennsylvania organizations and individuals warned Gov.-elect Tom Corbett about a crisis that will hit within weeks after he takes office.

The bare-bones health-insurance program called adultBasic could run out of funding by the end of February - and 43,000 current participants would lose their lifeline to medical care. Like thousands of other Pennsylvanians, they would have to wait until 2014, when the health-care-reform law will become fully operational. The impact of so many people being thrown off the rolls at once would be devastating, not only for those who would lose their safety net but for health-care providers and the general economy.

AdultBasic participants are substantially better off than 464,000 of their fellow citizens who are on the waiting list for the program, which was designed for people who are too young for Medicare, slightly too "rich" for Medical Assistance but with incomes below 200 percent of poverty: $21,660 for an individual.

The crisis is a snapshot, not only of the devastating impact of the Great Recession - the waiting list has grown by more than 300,000 since 2007 - but also of how inexorably the cost of health care has outstripped the ability of average Pennsylvanians to afford it. Without the subsidy, the plan costs more than $600 a month.

Over nine years, the program - begun by Gov. Tom Ridge with funds from the big tobacco settlement - has offered basic coverage (excluding prescription drugs) for $36 a month for the happy few who could get it. Since 2005, adultBasic has been funded by contributions from Pennsylvania's four Blue Cross/Blue Shield organizations as part of a special agreement negotiated by Gov. Rendell at a time when the "Blues" were under intense criticism for high surpluses. While the agreement was supposed to end Dec. 31, the Blues agreed to continue funding for a time, but the money will give out in a couple months.

In a report last summer, the nonpartisan Pennsylvania Budget and Policy Center provided this snapshot of adultBasic recipients: They are from every county in Pennsylvania, with slightly higher usage in rural communities. About 70 percent are white and 63 percent are female. In short, these are the constituents of every member of the Pennsylvania General Assembly - and so are the doctors who treat them and the hospital emergency rooms where many will end up receiving uncompensated care. And so are the businesses that will lose customers as tens of thousands of Pennsylvanians will have to choose between paying for health care and buying food or clothes or gas. We urge them to take seriously the repercussions of allowing this program to end.

The letter to Corbett, which was organized by the Budget and Policy Center and the Pennsylvania Health Access Network, was signed by representatives of religious groups, unions and advocates for the poor, and also by some health organizations. They reminded Corbett that, during his campaign, he promised to "preserve insurance for 90 percent of Pennsylvanians who have it."

It pleaded with him to work with the Blues to extend funding, and asked for a meeting "to discuss options to preserve adultBasic until 2014."

The advocates tactfully didn't mention the fact that as attorney general, Corbett joined a lawsuit to repeal the Affordable Care Act.

But we will: The exploding waiting list for adultBasic - and the increased costs of providing even no-frills health care - is compelling evidence of how desperately the relief promised by health-care reform is needed. And how self-destructive its repeal it would prove to the commonwealth.

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