PHAN Hosts State-Wide Call on AdultBasic

"The clock is ticking. We only have three weeks left to save the program." Sharon Ward, Executive Director of the Budget and Policy Center, stressed on last night's policy call. She was referring to adultBasic, the call's topic and the health insurance program over 42,000 Pennsylvanians stand to lose in 3 weeks.

The call itself was part of the PHAN Policy Call Series - next week's is on repeal efforts around the Affordable Care Act and how we can most effectively stand up to those. Margarida Jorge, National Field Director for Health Care For America Now, will discuss both legislative and judicial initiatives. We'll also be joined by PHAN's Project Director, Antoinette Kraus, who will bring us up to speed on what's happening in our state. If you haven't RSVP'd for that call which is Tuesday, Feb 15th at 6:00 PM, email me at aford@pahealthaccess.org for dial-in numbers.

Below, is an overview of the entire call from last night. Scroll down to the pieces you're less familiar with.

What it is and who's in it

Ward explained adultBasic is a completely state funded basic health insurance option (no mental health coverage, for example) for childless adults or those making too much for Medicaid. It costs participants $36/month and does not discriminate against people with pre-existing conditions. The majority of the 42,000 Pennsylvanians on the program are working, live in rural areas, white, between 36-64 years old, live all over Pennsylvania and have been on the program for at least 3 years.

How it came to be

AdultBasic was started under Governor Ridge by use of dedicated funds from the tobacco settlement money. (When a bunch of Attorney Generals sued the tobacco companies and got money for health related costs). In PA, all of that money was set aside for health coverage and about 30% of it was directed towards adultBasic. 30% meant about 100 million which was enough to cover approximately 35,000 people.

2004 saw an outcry across the state over the skyrocketing surpluses of the non-profit 'Blues.' Governor Rendell then negotiated an agreement, the Community Health Reinvestment Agreement (CHR Agreement)t, that called for a portion of the Blues' profits to help fund adultBasic. The agreement, however, was set to expire in December 2010.

Over time, there have been attempts to expand adultBasic or to add additional funding streams. these have mostly failed and with the recession in 2007 the program was capped and a waiting list now reaches nearly 1/2 a million people.

So, what happened?

Last summer there were discussions going on - what was going to happen when the CHR Agreement expired? An 'agreement' was reached that the Blues would continue funding the program through June 2011 and the new Governor, Tom Corbett, would need to figure out a way to save it from there. (This wasn't the same type of agreement as the CHR Agreement - it wasn't, for example, a legal signed agreement).

For a variety of reasons, including insufficient contributions from the Blues, not enough money was brought in to continue the 6 month extension through June 2011. Rendell alerted Corbett's administration that there was insufficient funding and offered solutions that the Corbett administration did not find to be acceptable.

Where is Tom Corbett on this?

Governor Corbett has requested the use of funds from the PA Fair Care Program, a health insurance program for people with pre-existing conditions founded by the Affordable Care Act. However, that has been denied, as expected, because of the 6 month go bear period. (To go into PA Fair Care, an individual has to be uninsured for atleast 6 months.)

Corbett's administration also allowed for a letter to be sent out to all adultBasic recipients indicating that adultBasic will expire. Their 'solution' is to make people on adultBasic purchase Special Care. Special Care has been around for over 30 years and is the reason why programs like adultBasic were created, Ward pointed out. It discriminates against people with pre-existing conditions, costs 300-400% more per year and has sever limitations of coverage like capping doctors visits to 4/year.

What have our legislators done to help?

The General Assembly has been involved in this effort. There was a press conference 2 weeks ago where a number of legislators working to save the program announced their commitment to the issue. Representative DeLuca has entered HB 500 which would allow the Insurance Commissioner to use additional funds to save the program, including funds that have surpluses.

A Senate bill with additional funding streams will be introduced within a week.

We need a long term solution.

Let's take our 6 month extension if we get it, but ultimately we need a long term strategy. The Blues surpluses have grown to 5.9 billion dollars since they started funding adultBasic - or over 7 billion if you count out of state subsidiaries.

What do I do if I'm on adultBasic?

You need to contact a health care navigator and see if there is another program you could qualify for. There is one you can contact at the Philadelphia Unemployment Project (no matter where in PA you live) reach Katy at: 215-557-0822 ext 106. Consumer Health Coalition in Pittsburgh you can contact at 412-456-1877.

Also, send us your story! If your are comfortable sharing your story send them to us at aford@pahealthaccess.org.

Want to see the program saved?

Call your state representative and state senator. Call Tom Corbett. Call every day.

PHAN's Policy Call Series

The above is, believe it or not, just a snippet of the amount of information that was offered by Sharon Ward and is fairly typical of what you get from our call series. Our expert speaker always starts from the beginning - so you never have to feel intimated to listen in. Then, s/he talks you through some of the more nitty-gritty details. There is always a question and answer period, a simple call to action and the call is over before 7. RSVP today for next week's about repeal efforts - aford@pahealthaccess.org - to receive dial-in instructions.