Six Months after the End of adultBasic

A blog post by Sharon Ward, originally published at Third and State.

It has already been six months since Pennsylvania pulled the plug on the adultBasic health insurance program for 37,588 people. The Pennsylvania Budget and Policy Center recently took a look at what happened to the Pennsylvanians who lost their adultBasic coverage on the first of March. While some found health insurance elsewhere, many have simply fallen through the cracks.

In all, fewer than 40% of former adultBasic enrollees have enrolled in Medical Assistance or Special Care, a low-cost, limited benefit product offered by Pennsylvania’s Blue Cross/Blue Shield plans. These were the two options most touted as alternatives for adultBasic enrollees.

According to data provided by the Pennsylvania Departments of Public Welfare and Insurance, only 12,814 former enrollees signed on to the Blues’ Special Care — about 34% of those enrolled in adultBasic when it ended. Special Care came at a cost four times more expensive than adultBasic, and with limits on medical coverage including a four-doctor-visits-per-year cap that may have kept it out of reach for most adultBasic enrollees.

Only 1,513 qualified for health coverage under Medical Assistance — 4% of those enrolled in adultBasic when it ended. AdultBasic was designed to provide health coverage to working adults who didn’t qualify for Medical Assistance but weren’t provided job-based health coverage. Still, many adultBasic enrollees might have qualified due to special circumstances: pregnancy, a diagnosis of breast or cervical cancer, or a disability. Despite a thorough review of cases by the Department of Public Welfare, fewer than expected adultBasic recipients are enrolled.

After six months, 62% of adultBasic enrollees, 23,261 individuals, are not enrolled in the two main alternative programs offered by the Pennsylvania Department of Insurance when the program closed.

Leaving people uninsured brings with it significant costs: to the individuals, and to the public who pays for their medical treatment at hospitals and, when the uninsured become the unemployed, for additional social services.

Under the federal Affordable Care Act, many former adultBasic enrollees will have access to insurance that they can afford when competitive insurance marketplaces open in January 2014. But that is a long time to wait for those who have fallen through the cracks.

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