300,000 waiting for subsidized health care : JO CIAVAGLIA
By: Health Insurance
Submitted: 2009-08-17 11:18:45 | Word Count: 791
People waiting for an opening in Pennsylvania's subsidized health program have been uninsured for at least three months.
The waiting list for Pennsylvania's subsidized health insurance program is nearing 300,000, a number that has more than tripled since the economic recession began 18 months ago. But state officials have no plans to stop accepting names.
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In the last eight months, the number has doubled with seven times more people waiting to get into the adultBasic health insurance program than currently are receiving the benefits.
As of last month, 288,864 low-income residents had qualified for the state program compared with less than 45,000 enrolled, according to the Pennsylvania Insurance Commission, which oversees the program. In December 2007, the waiting list had 95,656 names.
"It's absolutely worrisome," said Melissa Fox, a spokeswoman with the insurance commission. "The funding stream is not there for the people who need coverage. It's very discouraging."
To qualify for adultBasic - even to get on the waiting list - you must be uninsured at least three months and not qualify for other government health programs for low-income, non-elderly people.
Under the program, started in 2002, beneficiaries pay a $35-a-month premium and copays for doctor or emergency room visits. Prescription drugs and behavioral health services are not covered.
Gov. Ed Rendell requested his 2009-10 budget expand enrollment in the adultBasic program to at least 90,000 - more than doubling the current enrollment as part of his Prescription for Pennsylvania health reform. Rendell also asked the Legislature to add prescription drug and behavioral health coverage to the program.
The expanded adultBasic would cost the state between $116 and $138 per enrollee, per month, depending on family income, according to the Governor's Office on Health Care Reform.
The federal government would pay more than 50 percent of the costs and the coverage would include prescription and behavioral health benefits for both current and new enrollees.
But the state Legislature remains without a budget more than one month into the new fiscal year, though the adultBasic proposals remain on the table as part of negotiations, said Amy Kelchner, a spokeswoman with the Governor's Office on Health Care Reform.
The governor's proposed adultBasic expansion is similar to a Democrat plan that would expand it more and use different funding sources, Kelchner said.
The Center for American Progress estimates 1.3 million American workers lost health coverage in the first four months of 2009 based on census and labor statistics.
Nearly three-quarters of the 2.8 million uninsured Pennsylvanians under age 65 went at least six months without health coverage in 2007 and 2008, according to a national consumer health care advocacy group report released in March
Since the recession began, the subsidized health program's enrollment has dropped from 51,056 to 44,602 as of last month, according to the insurance commission. The reason for the drop in enrollees is a lack of state funding, Fox said.
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The commission has not surveyed why people have dropped out of the program, spokeswoman Rosanne Placey said. They may have secured health coverage elsewhere or their income changed, or they require more than basic medical benefits, she said.
Also unclear is how many on the waiting list no longer qualify or need the subsidized coverage since the list is reviewed only when someone comes off the list, Fox said.
The last time people moved off the list was in March when 16,370 people entered adultBasic, Placey said.
They had waited at least 18 months for coverage. Prior to then, the last time the waitlist was reduced was January 2008 when 29,368 came off it.
Those joining the list now can expect at least a two-year wait. "It's the largest waiting list we've ever had," Placey said.
With such a long backlog, the program has seen a slight increase in people on the waiting list buying the coverage at the state's cost - $330 a month - while they wait for an program opening.
When the recession began 2,478 were paying the full premium; as of last month the number was 3,125.
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