adultBasic: A Year of Struggle

One year after Pennsylvania’s adultBasic program came to an end, many working Pennsylvanians are still struggling with the lose of this critical lifeline. Anxiety and financial pressures are common, and many are allowing chronic health conditions to go untreated.

That was the message delivered by health care providers, advocates and former adultBasic enrollees during a media conference call hosted by the Pennsylvania Health Access Network (PHAN) Wednesday.

adultBasic was created more than a decade ago to provide affordable health coverage to low-income working Pennsylvanians who either lacked job-based coverage or were denied outright because of pre-existing health conditions.

But when a funding agreement between the commonwealth and Pennsylvania’s four Blue Cross/Blue Shield plans expired, Governor Corbett opted to end the program rather than renegotiate the agreement. The adultBasic program shut down one year ago today.

Rick Mossinghoff, a part-time worker from Robinson Township, Allegheny County, was one of the Pennsylvanians who suddenly found himself without health coverage. He opted to enroll in Special Care – a plan for low-income people offered by the Blues and touted by the Corbett administration as an alternative. His new premiums were five times the cost of adultBasic.

“When I had adultBasic, I was able to have physical therapy to combat the arthritic degeneration in my hip,” Mossinghoff said during the conference call. “That all ended, when I lost my coverage – because Special Care doesn’t cover any rehabilitative or physical therapy care.”

He later added: “Special Care has been a nightmare for me. We are limited to just four doctor visits a year. Here we are, barely into the new year, and I’ve used up four of my visits trying to get my hip straightened out. My doctors told me that if I didn’t have physical therapy, I’d walk with a limp the rest of my life.”

Mossinghoff ended up shopping around for physical therapy, took the lowest bidder and is paying out of pocket.

And he’s probably doing better than many other former adultBasic enrollees. As the Pennsylvania Budget and Policy Center showed in a fall report, fewer than 40% of those who lost adultBasic coverage enrolled in Special Care or the state’s Medical Assistance Program. The other 60% have simply fallen through the cracks.

The Blues’ plans, meanwhile, continued to do quite well despite the recession. Reports show the plans had a combined surplus of $6.4 billion in 2010.

The only light at the end of the tunnel for those who lost adultBasic is the Affordable Care Act, which calls for new insurance marketplaces to buy affordable health coverage to be up and running by 2014. Only then will Pennsylvania families be able to access the kind of choices and security that are lacking in our current health insurance market.

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