“Basic” health care in PA is getting more expensive
People who get their health coverage through Pennsylvania’s low-cost insurance program may experience sticker shock soon. The AdultBasic plan is raising rates and cutting benefits.
People who get their health coverage through Pennsylvania’s low-cost insurance program may experience sticker shock soon. The AdultBasic plan is raising rates and cutting benefits.
Listen: [audio:100114tebasic.mp3]
Forty-thousand low-income people are enrolled in the state-subsidized health plan. Those members will pay an extra $5 to $25 out-of-pocket for doctor’s appointments or emergency room visits. The steepest price hike is for people on the AdultBasic waiting list who buy into the plan. About 3,500 people pay full cost while they wait for space to open up in the subsidy program. In March, their average monthly premium jumps to $600, up from $330. Swarthmore resident Tom Jenik says he’s not sure he can pay the new rate.
Jenik: You’ve already identified this pool of people as people who can not afford the full premium for health insurance so essentially I think you’re taking the must vulnerable people and asking them to pay more when the only reason they got the insurance was because they couldn’t pay.
The 61-year-old says the AdultBasic plan was his only option after several insurance companies denied him coverage because he has arthritis. Insurance commissioner Joel Ario says the General Assembly has rejected several attempts to better fund AdultBasic.
Ario: With the budget crisis, if we don’t get federal health reform it will be very difficult to find money at the state level to expand the program.
Ario says, until there’s a federal fix, private and public insurance programs will be forced to shift costs to plan members.
Ario: We are dealing with people that are of limited means but we aren’t dealing with people below the poverty line — those people are in the Medicaid program. So to pay $10 for an office visit is way lower than the market. On the whole, I wish we didn’t have to make any of these changes — but that one — to me — seems modest and reasonable given the choices we face.
State officials say medical costs are escalating and member requests for health care have increased, too.
WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.