Pennsylvania cuts health insurance plan for low-income adults

Mary Lou Jay

Finding affordable health insurance became a little harder in Pennsylvania in February 2011, when the state discontinued its adultBasic health insurance program. Since 2001, adultBasic had provided subsidized health insurance coverage for adults age 19 to 64 whose incomes were too high for them to qualify for other government programs.

The income limit in 2010 was 200 percent of the federal poverty level, according to a budget briefing from the Pennsylvania House Appropriations Committee. At the start of 2011, individuals enrolled in the adultBasic program paid only $36 a month for their coverage, although the full cost was $636 a person. The state initially financed the program using money from its tobacco settlement funds, according to the Pennsylvania Insurance Department. A few years later, the state's Blue Cross and Blue Shield programs also began contributing, although their contributions would have stopped in June 2011.

When Gov. Tom Corbett took office this year, however, he announced that the adultBasic program was bankrupt. Faced with a $4 billion state deficit, he said the program would end as of Feb. 28, 2011.

Pennsylvania Democrats have tried to find other funding sources for the program, and one advocacy group has threatened to sue the state over its demise. But at this point it's unlikely that adultBasic will continue.

That means that since March 1, 2011, roughly 42,000 Pennsylvanian have been without adultBasic coverage for doctor appointments, hospitalizations, tests and other medical treatments (like radiation or chemotherapy).

The Pennsylvania Insurance Department has suggested some alternatives for those who have lost their adultBasic coverage:

  • If your income has decreased, you may apply to the state's medical assistance program to see if you now qualify.
  • You may be able to purchase SpecialCare coverage, which is provided through Pennsylvania's Blue Cross and Blue Shield plans. The benefits are more limited and the cost is higher than the adultBasic coverage.
  • Try to obtain coverage through an employer.
  • Apply to PA Fair Care, which is the state's medical insurance program for people with pre-existing conditions. However, there would be a waiting period, because people must be without insurance coverage for six months before they can apply for this program.
  • Try some of the state's 200 community health centers, which charge for care based on a patient's ability to pay.
  • Several specialized programs are available for women, disabled workers and those who can't afford their prescription drugs.