2009-02-05 / Features

Pa. Survey Says 1 Million Lack Health Insurance

By Martha Raffaele ASSOCIATED PRESS WRITER

HARRISBURG, Pa. (AP) - The number of Pennsylvania residents without health insurance has increased to more than 1 million, according to a state Insurance Department survey released Thursday.

The debate over how to reverse the trend has already created a deep divide between Democratic Gov. Ed Rendell's administration and Republicans who control the state Senate. Reaching a compromise this year could prove more difficult as the state tries to tackle a mounting budget deficit.

The uninsured account for more than 8 percent of all state residents, up from 7.5 percent in the department's last survey in 2004. More than half have been without coverage for a year or less, while nearly 18 percent have been uninsured for more than five years.

The new survey was conducted between September 2007 and May, and the subsequent national recession has likely further increased the number of residents who lack health coverage, Insurance Commissioner Joel Ario said.

"With unemployment going up and the other trends in the economy, the situation is likely significantly worse today that it was back in May of '08,'' Ario told a news conference.

The findings were drawn from a random telephone survey of nearly 50,000 Pennsylvanians by Market Decisions, a Portland, Maine-based market research and consulting firm. The department paid the company $740,000 to conduct the survey, Ario said.

The survey found that the overwhelming majority of the uninsured, nearly 90 percent, are adults. Close to two-thirds said the high cost of insurance was the reason they had no coverage, and other reasons included losing a job and making too much money to qualify for state-sponsored insurance.

The poorest Pennsylvanians are covered by Medicaid. The state also provides insurance through its adultBasic program for working poor adults whose incomes are too high to qualify them for Medicaid; the adultBasic annual income eligibility range for a family of four is $6,800 to $42,400.

Pennsylvania also provides free and low-cost health care to nearly 184,000 children through its Cover All Kids program. Families with household incomes that exceed eligibility limits for a partial state subsidy can obtain coverage by paying the full premium if they meet certain criteria.

The number of people the state can afford to cover is far outstripped by the adultBasic waiting list.

AdultBasic currently covers about 45,000 adults. Four times that many people are on the waiting list, which is projected to balloon to 282,000 by the end of June, Ario said.

Established in 2002, adultBasic is funded with money from the cash surpluses of Pennsylvania's four nonprofit Blue Cross and Blue Shield insurers and from the state's share of a national settlement with major tobacco companies.

Although the state spends about $150 million a year on the program, rising health care costs have forced it to reduce the number of people covered, Ario said. The average number of adults insured annually by adultBasic peaked at 52,000 during the 2006- 07 fiscal year.

Rendell is continuing a push begun two years ago for an expansion of government-subsidized health insurance. Republicans who control the state Senate have resisted, saying his plan is too expensive.

Potential funding sources include part of a surplus from a state fund that helps doctors pay for medical malpractice insurance and a proposed new tax on cigars and smokeless tobacco.

Sen. Edwin B. Erickson, RDelaware, said he was working on legislation that would authorize a smokeless tobacco tax, even though he acknowledged it would be controversial among his GOP colleagues.

"Let's take some of that and use it to address some of the waiting list,'' said Erickson, chairman of the Senate Public Health & Welfare Committee.

Sen. Don White, an Indiana County Republican who heads the Senate Banking & Insurance Committee, isn't inclined to support a tax increase, said Joe Pittman, White's chief of staff.

"We have long favored increasing competition in the health insurance marketplace, promoting things such as health savings accounts and other avenues of providing access to health insurance," Pittman said.

And merely reducing the waiting list will not necessarily improve access to health care, Erickson said. Republican senators are planning to reintroduce measures proposed last year to achieve such goals as broadening the network of free health clinics for the poor, he said.

Rendell is also hoping for help from Washington. A spending package under consideration by Congress includes aid to states "for health-related issues," Rendell spokesman Chuck Ardo said.

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