Pennsylvania Access to Basic Care - Low Cost Health Insurance for Adults (SB 1137)

Over the next five years, an additional 200,000 adults who have been uninsured for at least 180 days would be able to buy quality private health insurance at a price they can afford.

• Adults in households making less than 200 percent of poverty ($20,800 for a single adult, 42,400 for a family of four) would pay between $0 and $50 per month for health insurance.
  
  
• The insurance plan would include prescriptions, annual check-ups, inpatient and outpatient care (including behavioral health services), chronic disease management, maternity care, emergency care (including some dental), skilled nursing, and home health and hospice care.
  
  
• Uninsured adults in households making over 200 percent of poverty could pay the full cost of $311 per adult per month, a good option in the case of serious medical need.
  
  
• Small employers whose average pay across their workforces is less than $15 an hour would be offered subsidized insurance for their workers.  Employers would pay $155 per month per employee; employees would pay between $0 and $155 per month, depending on household income.
  
  
• $42 million in grants would be available to small employers already offering a health plan to help them cover their insurance costs.

Access to Basic Care (ABC) would be financed by:

• Premium payments made by insured individuals and by employers who buy ABC for their employees.
  
  
• Surplus funds in the Health Care Provider Retention Account that are not needed for MCare, which is the state’s plan to provide physicians with half their medical malpractice protection; this account is funded by taxes on cigarettes and by premium payments from physicians.
  
  
• Existing adultBasic funding from Tobacco Settlement & Community Health Reinvestment dollars.
  
  
• Redirected uncompensated care funding for hospitals beginning in 2009-10.
  
  
• Additional taxes on tobacco products (smokeless, cigars and cigarettes).
  
  
• Federal matching funds.

ABC is not an entitlement.  The number of individuals enrolled each year would depend on the available dollars and the cost of coverage as bid by private insurers competing for the opportunity to engage in this business. To read the bill, click here.