PUP

Pittsburgh Post-Gazette
January 17, 2011

Editorial

Basic care: Corbett can get a better deal for the working poor

Gov. Ed Rendell hasn't moved out of his office yet and already adultBasic health insurance, expanded during his watch, is being dismantled.

The popular program, which enrolls 41,424 of Pennsylvania's working poor, was created in 2001 to provide basic coverage for low-income adults who earn too much to qualify for Medicaid but not enough to purchase other insurance. Under Gov. Tom Ridge, it was funded with tobacco settlement money, but later Mr. Rendell negotiated a commitment from the state's Blue Cross-Blue Shield companies to make significant, voluntary contributions to it.

He had leverage because the so-called nonprofit insurers -- including Highmark in Western Pennsylvania -- were under scrutiny due to their large surpluses. Today, the surpluses are bigger than ever, but the lame-duck governor wasn't as persuasive. Last year, Senate Republicans negotiated a temporary extension that was supposed to support the program until June, but adultBasic will run out of money next month.

While the outgoing and incoming administrations argue over who is to blame, Gov.-elect Tom Corbett's transition team for insurance has proposed an inadequate remedy. The team's chairman, lawyer David F. Simon, said moving adultBasic subscribers to the Blues' Special Care plan would provide "as soft a landing as possible." We're glad he isn't a pilot.

While adultBasic costs $36 a month, premiums for Special Care are far higher. More problematic than the price tag is the reduced service.

Special Care subscribers are limited to four doctor visits per year, compared to unlimited visits under adultBasic; the payments for diagnostic services are capped at $1,000, which is inadequate to cover many tests; and there is no coverage for in-home medical equipment such as crutches, wheelchairs or nebulizers. Also troubling is the lack of consistency among the Special Care plans offered by the four different Blues companies.

Paying more for far less doesn't seem like a good deal, especially considering that the surpluses of the Blues have been going nowhere but up.

The incoming governor can save adultBasic, and he shouldn't have to spend state dollars to do it. Mr. Corbett is in a position to extract a meaningful contribution from the state's nonprofit insurance providers and, if he starts working on it right away, he could save this valuable program before it dies.

 

 

site design KC Ellis