Not So Special Care

It has been just about six weeks since the adultBasic program came to an end, leaving 42,000 Pennsylvanians without affordable health insurance coverage. Governor Corbett ended the program, claiming that the state, and the Blues, were too poor to continue funding it.

Never mind that the Governor took $220 million in health care money to create a new business loan fund, or that Highmark just keeps raking in the dough. (More about that later.)

AdultBasic enrollees were encouraged to sign up for Special Care — a Blues product most notable for its winning combination of expensive premiums and lousy coverage — through two letters sent to recipients and in numerous phone calls with the soon-to-be uninsured. Their new friends, the Blues, would be only too happy to accommodate the newly uninsured.

So how’s that working out? Turns out, not so well.

In a press conference with Mayor Michael Nutter and Senators Michael Stack and Larry Farnese, Auditor General Jack Wagner released data on Special Care enrollment. It turns out that only 8,000 of 37,000 adultBasic enrollees (about 21%) have signed up with the Blues.

The enrollment varies widely among the four plans. Highmark, which had the largest adultBasic enrollment, 21,000 individuals, had 19% sign up. Independence Blue Cross' numbers are abysmal — only 6.7% of the 12,000 eligible individuals have signed up for Special Care.
adultBasic Customers Enrolling in Special Care
Get a PDF of this chart

So what happened to the other 30,000? Some may be eligible for Medical Assistance, and our good friends at Community Legal Services pushed hard to ensure that the Departments of Public Welfare and Insurance took affirmative action to find and enroll them.

But the rest may simply have fallen through the cracks.

On May 3, the window for adultBasic enrollees closes, and the Blues get to reduce income eligibility and reinstate pre-existing condition exclusions. The insurance companies are back in charge.

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