Demand For Pa.'s Health Insurance Help Overflows
HARRISBURG, Pa. (AP) - When Pennsylvania launched a low-cost health insurance plan for adults in 2002, it was designed to meet a pressing need.
Seven years later, the cost of private insurance has spiraled and that need is overflowing: 205,000 names are on the waiting list for adultBasic, many more than the number who actually get coverage.
In February alone, the waiting list ballooned by a one-month record of 25,000 people.
Jessica Portalatin, a 34-yearold divorced mother of two, drives a school bus in Lancaster County and said she's been on the waiting list since December 2006. Her employer does not offer benefits, and daily sinus pain and headaches make life without insurance nerve-racking.
"I'm my children's only caregiver. What's going to happen to them should I become really sick?" she said Friday. "That has me really worried."
In the two years since Portalatin signed up for adultBasic, the waiting list has tripled while proposals in the state Capitol to expand the availability of health care and health insurance have become mired in debates and hearings.
AdultBasic was designed to help the working poor who fall into a gap: not poor enough to qualify for the state-federal Medicaid program and not wellenough paid to afford private insurance.
The monthly premium is about $35, and income limits are on a sliding scale, depending on the family size.
About 43,000 are covered now, but the state government is not putting nearly enough money into adultBasic to meet demand, as the recession strips even more people of their jobs and benefits.
Last week, Gov. Ed Rendell said the state has enough money from attrition and program savings to offer coverage to another 16,000 people who have been on the waiting list since at least Feb. 13, 2007.
Not all 205,000 on the list still qualify. Some may have found health insurance through a new job, or some may have become poor enough that they are now eligible for Medicaid, Insurance Department spokeswoman Rosanne Placey said.
But for someone who has no health insurance, there is a small universe of options if he or she does not make enough to afford the full cost of a plan.
People who are on the adult- Basic waiting list can buy program coverage at the full cost - which averages about $330 a month and does not include prescription drug coverage.
Low-premium, high-deductible plans are offered by many insurance companies. Several hundred free or low-cost community clinics in Pennsylvania will, at a minimum, provide primary care.
Others may be able to work out a payment plan or a lower rate with their doctor's office.
The best option for someone who was laid off after Sept. 1 might be the COBRA benefit, the group health insurance that terminated workers may continue at full cost through their former employers. Under the federal economic stimulus plan signed last month by President Barack Obama, the government will pay 65 percent of the monthly COBRA premium for nine months.
In the last few months, more and more patients like Portalatin have been coming through the doors of hospitals and health clinics.
Admission officials at Geisinger Health System's hospitals in Danville and Wilkes- Barre are noticing more people who qualify for charity care or who are covered by Medicaid.
In Luzerne County, the Back Mountain Free Medical Clinic has seen the number of people in need of care double in the last five months, coordinator Ann Marie McNulty said.
At the Catholic Charities Free Health Care Center in Pittsburgh, it is common for people on the adultBasic waiting list to seek help from the volunteers there. Recently, the clinic has been treating more people who were just laid off, administrator Diane Redington said.
Ashley Byrd, 25, is working part-time as an administrative assistant and looking for a fulltime job so she can pay off her student loans and move out of her parents' Pittsburgh home.
She has been on adultBasic's waiting list since the end of 2007 and gets health care at community clinics.
"It's very satisfactory if you don't have any insurance, but it is stressful," she said.
Laid off in August, Tara Webb of Philadelphia doesn't believe she can afford health insurance after she already tapped her retirement savings to stay current on her mortgage and other bills.
She's looking for work and believes she'll find something eventually. But at 41, she's scared to be without insurance.
"I need the dental care, I need the doctor's visits, I'm over 40, I need to get a mammogram," she said. "In these last few months, so many of my friends have been diagnosed with breast cancer and died from breast cancer, I'm like, 'Oh, my God."'
Marc Levy covers state government for The Associated Press in Harrisburg. He can be reached at mlevy(at)ap.org.