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Advocates say rescue of state health insurance not enough

| Thursday, Jan. 13, 2011

HARRISBURG -- The adultBasic health insurance program was "a godsend" to Nick Balandiat of Baldwin.

The state-subsidized insurance program, essentially for the working poor, costs each participant $36 per month. But a lack of funding means the program expires Feb. 28.

Gov.-elect Tom Corbett, who takes office Tuesday, has a plan that would allow Balandiat and others on adultBasic to participate in the Special Care program of Blue Cross Blue Shield affiliates. There's no state subsidy, and the cost would increase to between $80 to $190 per month.

Balandiat, 50, who is unemployed with a long-term medical condition, said he can't afford the higher premiums.

"It (Special Care) doesn't cover much, and people with health problems or the working poor are not going to be able to afford the $190 per month," Balandiat said.

Corbett's transition team said he had to step in because outgoing Gov. Ed Rendell wasn't notifying recipients of the termination and had no plan to cover people on adultBasic. They said they negotiated with the "Blues" to accept people like Balandiat with pre-existing conditions that might prevent them from obtaining insurance.

The state's projected $4 billion deficit makes cuts likely throughout state government. As Corbett takes office, there is no money to fund adultBasic, spokesman Kevin Harley said.

In a letter to legislators this week, Rendell said Corbett could temporarily borrow from the state's tobacco settlement fund to fund adultBasic through June 30 and ask the Legislature to replace the borrowed money.

"It is highly regrettable we have reached this point," Rendell said.

Rendell was able to fund more than $400 million worth of projects across the state but couldn't find $56 million to cover adultBasic through June, Harley said.

If the Legislature offers an alternative to the Special Care program, Corbett will consider it, Harley said.

"Corbett is being proactive in dealing with another Rendell mess," said House Majority Leader Mike Turzai, R-Bradford Woods.

There is no reason Blues Cross affiliates, with multibillion-dollar surpluses, couldn't cover the people in adultBasic until the Legislature finds more money, Rendell said.

Critics say Special Care is too costly and covers too little.

"Special Care covers only catastrophic care in the hospital and limited coverage for outpatient care," said Laval Miller-Wilson, executive director of the Pennsylvania Health Law Project and a member of the Pennsylvania Health Access Network.

"Special Care is very costly and has limited benefits," said John Dodds, director of the Philadelphia Unemployment Project and a member of the network.

Every effort will be made to determine which adultBasic participants are eligible for Medicaid, said Tom Paese, co-director of Corbett's transition team, whose lobbying firm represents Highmark, one of the Blue Cross affiliates. Special Care is not ideal, he said, but it is better than having no insurance.

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