Issue Brief

Access to Health Care

The Future of adultBasic and the Community Health Reinvestment Funds

By the time President Obama signed federal health care reform legislation into law, both Republicans and Democrats agreed that the current health care system is fundamentally flawed.  Unfortunately, the one million Pennsylvanians who are uninsured still have to live with that system for the next four years.  In fact, forty thousand Pennsylvanians who are insured through the adultBasic program could lose their health coverage unless the General Assembly takes action.

Did you know that in Pennsylvania…?

·     The waiting list for adultBasic has grown from 80,000 to 400,000 people in two years, yet the General Assembly has not taken action to significantly expand enrollment beyond the 40,000 to 50,000 that are covered at any given time.

·     3,ooo people, who pay the full unsubsidized cost for adultBasic coverage because it’s the only insurance they can get,  recently saw premiums double from $300 to $600 a month.

·     The major funding source of adultBasic, the Community Health Reinvestment Funds paid to the state by the four Blue Cross non-profit insurance companies, will expire at the end of 2010 without legislative action.

Consequences of lack of Health Care:

Many of the uninsured access health care primarily via emergency rooms, when medical problems are acute.  If they suffer from a chronic disease, a medical professional is not regularly managing their treatment.  The uninsured often cannot afford to fill their prescriptions or, if they do, they cannot afford to take prescription drugs in the recommended dosages.  This inability to properly care for their health leads to decreased productivity for Pennsylvania’s workforce.

What has the ELCA said about Health Care?

The ELCA passed the social statement “Caring for Health: Our Shared Endeavor” in 2003 and reaffirmed the need for public advocacy around health care at Churchwide Assembly in 2009.  While Lutherans may not agree about how to structure our health care system, the statement reminds us that “Health is central to our well-being, vital to relationships, and helps us live out our vocations in family, work, and community”.

adultBasic – A Program in Crisis

What is adultBasic?

During the administration of Republican Governor Tom Ridge, Pennsylvania began subsidizing a private health insurance plan, known as adultBasic,  for adults with incomes below 200% of the federal poverty level.  This made health insurance affordable ($36 a month) for individuals who otherwise could not afford it, including single adults with annual incomes below $21,660.  As funding for adultBasic, Pennsylvania has used tobacco settlement funds and, as those funds have declined, the state has increasingly used money contributed in lieu of taxes by the Blue Cross health insurance companies know as Community Health Reinvestment Funds. 

Why is adultbasic in Crisis?

The voluntary agreement reached between the Rendell Administration and the four Blue Cross insurers expires in 2010.  If legislation is not enacted to continue the Community Health Reinvestment funds, the adultBasic program will end, and the 40,000 individuals it serves will lose their health insurance.  With consumer protections that require companies to offer coverage regardless of pre-existing conditions not set to go into effect until 2014, adultBasic is often a low-income adult’s only option for coverage at a time when they can least afford to go without care.

No program, especially adultBasic, is without its flaws.  The health care costs of adultBasic participants are much higher than average because these individuals have often gone without insurance (and care!) until their medical problems became severe.  For this very reason, participants on the waiting list for subsidized coverage are allowed to pay full cost, and saw their monthly premiums double in March of 2010.  Legislation that continues the Community Health Reinvestment (CHR) funds could show a stronger commitment to adult health insurance by requiring a larger percentage of the CHR funds go towards adultBasic.  Currently it is only 60%.

What is LAMPa asking Advocates to do?

 Now is a crucial time to show your legislators that constituents are worried about the future of adultBasic and aware that its current funding is coming to an end. 

For the past two years, the House has passed measures to significantly expand adultBasic, but these measures have not been voted on in the Senate.  Policy makers are currently studying new federal regulations in order to ascertain the best way forward.  Once legislation related to adultBasic is introduced, LAMPa will be asking the ACTIONET network and LAMPa Ambassadors to follow up with state lawmakers to see where they stand on this important health issue.

 

April 2010