adultBasic: A Year of Struggle for Many Working Pennsylvanians

A blog post by Chris Lilienthal, originally published at Third and State.

One year after Pennsylvania’s adultBasic program came to an end, many working Pennsylvanians are still struggling with the lose of this critical lifeline. Anxiety and financial pressures are common, and many are allowing chronic health conditions to go untreated.

That was the message delivered by health care providers, advocates and former adultBasic enrollees during a media conference call hosted by the Pennsylvania Health Access Network (PHAN) Wednesday.

adultBasic was created more than a decade ago to provide affordable health coverage to low-income working Pennsylvanians who either lacked job-based coverage or were denied outright because of pre-existing health conditions.

But when a funding agreement between the commonwealth and Pennsylvania’s four Blue Cross/Blue Shield plans expired, Governor Corbett opted to end the program rather than renegotiate the agreement. The adultBasic program shut down one year ago today.

Rick Mossinghoff, a part-time worker from Robinson Township, Allegheny County, was one of the Pennsylvanians who suddenly found himself without health coverage. He opted to enroll in Special Care – a plan for low-income people offered by the Blues and touted by the Corbett administration as an alternative. His new premiums were five times the cost of adultBasic.

“When I had adultBasic, I was able to have physical therapy to combat the arthritic degeneration in my hip,” Mossinghoff said during the conference call. “That all ended, when I lost my coverage – because Special Care doesn’t cover any rehabilitative or physical therapy care.”

He later added: “Special Care has been a nightmare for me. We are limited to just four doctor visits a year. Here we are, barely into the new year, and I’ve used up four of my visits trying to get my hip straightened out. My doctors told me that if I didn’t have physical therapy, I’d walk with a limp the rest of my life.”

Mossinghoff ended up shopping around for physical therapy, took the lowest bidder and is paying out of pocket.

And he’s probably doing better than many other former adultBasic enrollees. As the Pennsylvania Budget and Policy Center showed in a fall report, fewer than 40% of those who lost adultBasic coverage enrolled in Special Care or the state’s Medical Assistance Program. The other 60% have simply fallen through the cracks.

The Blues’ plans, meanwhile, continued to do quite well despite the recession. Reports show the plans had a combined surplus of $6.4 billion in 2010.

The only light at the end of the tunnel for those who lost adultBasic is the Affordable Care Act, which calls for new insurance marketplaces to buy affordable health coverage to be up and running by 2014. Only then will Pennsylvania families be able to access the kind of choices and security that are lacking in our current health insurance market.

In Case You Missed It: Third and State Blog for Week of March 21

This week on Third and State,  we blogged about Marcellus Shale trickle down economics, the Affordable Care Act’s first birthday, unions and inequality, and much more!

In case you missed it:

  • On the Marcellus Shale, Mike Wood notes that trickle down economics is not helping the local communities across Pennsylvania hosting increased natural gas drilling.
  • On health care, Chris Lilienthal highlights a “consumers’ hearing” in the State Capitol Rotunda on the one-year anniversary of the Affordable Care Act’s passage. The hearing presented the perspective of Pennsylvanians who have benefited from the law – a perspective that was omitted from a congressional hearing on the landmark law also held at Pennsylvania’s State Capitol this week.
  • On federal tax issues, Chris blogs about an interview on WHYY’s Fresh Air that explained some of the accounting gimmicks that large corporations use to shelter income overseas and avoid as much as $90 billion a year in U.S. taxes.
  • On wages and income inequality, Mark Price shares research documenting that in economies where more people are covered by unions, there is less inequality.
  • Finally, Mark has this week’s Friday Funny: The Daily Show’s Jon Stewart takes on new governors, mean stepdads and confusion within the administration of Maine’s new governor about what exactly a mural is.

More blog posts next week. Keep us bookmarked and join the conversation!

In Case You Missed It: Third and State Blog for Week of February 28

This week on Third and State, we blogged about the upcoming state budget, the end of adultBasic, a questionable business climate ranking, and much more!

In case you missed it:

  • On the state budget and the economy, Sharon Ward shared a podcast featuring her and Jan Jarrett of PennFuture discussing the state budget principles that will create jobs and ensure the long-term economic success of the Commonwealth. Mike Wood, meanwhile, challenged comments made this week by Budget Secretary Charles Zogby that Pennsylvania’s budget woes are due to overspending. Mike points out that nearly every state in the nation – low-spending and high-spending alike – is facing a budget shortfall this year thanks to a recession-driven decline in revenue collections.
  • On the economy, Mark Price blogged about the problems with a new business climate ranking from the U.S. Chamber of Commerce that seems to favor states with lower wages and less human development. Mark also shared a funny but informative video of the Daily Show’s Jon Stewart discussing pay on Wall Street and for teachers. 
  • On health care, Chris Lilienthal highlighted a New York Times story on the end of Pennsylvania’s adultBasic health insurance program this week and what that means for the more than 41,000 Pennsylvanians who lost their coverage.
  • Finally, on jobs and wages, Stephen Herzenberg noted that The Economist agrees with the Keystone Research Center on one thing: people don’t take government jobs to get rich.

More blog posts next week. Keep us bookmarked and join the conversation!

In Case You Missed It: Third and State Blog for Week of February 21

This week on Third and State,  we blogged about the looming loss of health coverage for nearly 42,000 adultBasic consumers, a misinformation campaign on public- and private-sector pay, the problem with Arkansas’ gas drilling tax, and much more!

In case you missed it:

  • On health care, Chris Lilienthal blogged about the faith community’s call on Governor Corbett to preserve adultBasic health coverage for nearly 42,000 Pennsylvanians. Later in the week, Chris also wrote about a candlelight vigil planned for 5:30 p.m. February 28 outside the Governor’s Mansion to protest the end of adultBasic.
  • On public sector wages, Mark Price urged readers, in light of the battle over collective bargaining rights in Wisconsin, to beware of misinformation campaigns on the differences in public- and private-sector pay.
  • On the natural gas drilling tax, Michael Wood explains why a prominent Arkansas Republican, two-time gubernatorial candidate, and former gas company executive wants to increase his state’s natural gas drilling tax.
  • Finally, on jobs and the economy, Stephen Herzenberg cites New York Times economist David Leonhardt to explain why we need more action to create jobs.

More blog posts next week. Keep us bookmarked and join the conversation!

In Case You Missed It: Third and State Blog This Week

This week on Third and State, we blogged about the upcoming two-year anniversary of the Recovery Act, President Obama’s budget plan, a few hundred Valentine’s Day messages for Governor Corbett, sales tax loopholes that only could love, and much more!

In case you missed it:

  • On the state budget, Michael Wood detailed Amazon’s foot-stomping response to efforts by states to close a sales tax loophole that gives the online retailer an unfair competitive edge over other retailers. (Spoiler alert: The brick-and-mortar stores are none too happy about it!) Mike also shined some light on Pennsylvania’s “conservative” debt levels and explained that Pennsylvania’s debt service payments have long been low – between 3% and 4% of the state budget.
  • On health care, Chris Lilienthal shared some of the Valentines that Governor Corbett received this week from Pennsylvanians asking him to have a heart and save adultBasic.
  • On the federal budget, Chris highlighted some analysis from the Center on Budget and Policy Priorities on President Obama’s budget proposal for the 2012 Fiscal Year. Mark Price, meanwhile, shared a video clip of Columbia University Professor Jeffrey Sachs discussing the federal budget and noting that both parties have the wrong priorities by cutting services vital to working- and middle-class families.
  • Finally, on the economy, Mark Price takes note of the upcoming two-year anniversary of the passage of the American Recovery and Reinvestment Act. Mark also blogged that policymakers are focused on the wrong deficit – Main Street America is a lot more concerned about a deficit in jobs and wages than they are about the federal fiscal deficit.

More blog posts next week. Keep us bookmarked and join the conversation!

In Case You Missed It: Third and State Blog This Week

This week, the Keystone Research Center and Pennsylvania Budget and Policy Center launched a new joint blog, Third and State. Thanks to all of you who have checked it out.

In case you haven’t seen it, here’s what you missed:

  • On health care, Sharon Ward examines state legislation sponsored by Rep. Matt Baker that, if passed, would prevent Pennsylvania from moving forward with key provisions of the Affordable Care Act. The bill would be, Sharon writes, “a tremendous setback for Pennsylvanians who lack health insurance, but also for sole proprietors and small businesses that have no market power and have lived with double digit rate increases over the past few years.”
  • On jobs and unemployment, Mark Price asks if we can stop attacking people who have lost their job as a result of the Great Recession. In another post, Mark dispels myths about public-sector pay. Mark also writes about why Marcellus Shale development reminds him of the Ford Pinto debacle of the 1970s.
  • On the state budget, Michael Wood introduces the first in a new series of policy briefs called February Fiscal Facts. These briefs will shine a light on specific budget topics, starting with how Pennsylvania General Fund spending compares to other states. Chris Lilienthal also highlights the good news in Pennsylvania’s recent revenue report but warns that bigger fiscal challenges loom on the horizon.
  • And Steve Herzenberg takes on income inequality with a look at the “new normal” where a Hedge Fund manager can earn as much as 364,000 farm workers.

More blog posts next week. Keep us bookmarked and join the conversation!

True Cost of Healthcare Event this Thursday

( – promoted by John Morgan)

This Thursday, March 26th, Change That Works is helping to highlight the true cost of healthcare with an event in Allentown.  Anyone who is interested in sending a message to Washington about the need for healthcare reform will have an opportunity to bring personal stories straight to Senator Specter’s office.  From 11 AM until noon, local citizens will be meeting outside Specter’s Allentown office at 5th and Hamilton to share their urgent concerns for reform.

This is our opportunity to really have our voice heard directly and be a part of the debate to improve healthcare for everybody.  President Obama is investing over $600 billion in his budget for healthcare reform, but we need to drive the debate.  Senator Specter’s office has been open with the Change that Works campaign and offered to listen to some people right after the collection of stories on Thursday.  This is a perfect chance to get your thoughts on healthcare directly to one of the key legislators in Washington.

When:  11 AM, Thursday March 26th

Where:  Outside at 5th and Hamilton, Allentown

Contact:  Tony Heyl, 215-219-5987

“Getting Everyone Covered” Leaves Glaring Hole

HCAN, or Healthcare for America Now is sponsoring an event in Harrisburg on March 9th purportedly to examine methods of solving the state’s healthcare crisis.  The problem is that HCAN promotes an incrementalist approach which is impossible.  They advocate for rule changes in law to force health insurance companies to provide health care coverage.  Unfortunately, by law, each of these corporations is legally required to perform first and foremost for their owners and shareholders.  No rule changes can change that determination.

This is the primary problem with our broken system:  for profit health insurance companies.  They soak up 30% of all healthcare dollars before a single medical treatment is provided.  The hundreds of different companies duplicate all the overhead and bureaucracy which Medicare and other government programs (Medicaid, VA, etc.) do for 3% overhead.  This is why you cannot afford health insurance.

The only solution is single payer universal health care.  Interestingly the HCAN conference does not include any mention or spokesperson for single payer.  How can they realistically portray this as “Getting Everyone Covered” when that can only be done via single payer?  Why have they excluded single payer from such a conference?  No advocate for single payer has even been approached to represent this solution at their conference.

From the HCAN email:

The “Getting Everyone Covered” conference will bring together policy-makers, advocates and citizens who want to fix our health care system.  It will equip participants to join this movement and connect with other people pushing fo r reform.

Speakers will include a representative of the Obama Administration, Insurance Commissioner Joel Ario, Senate Public Health and Welfare Committee Chairman Ted Erickson, Pinnacle Health Chief of Endocrinology Dr. Renu Joshi, and many others.  Also invited are Governor Ed Rendell and senators Arlen Specter and Bob Casey.

So with all these important people gathered to discuss healthcare wouldn’t you expect any serious discussion and any group with any integrity to have invited someone from Healthcare For All PA?  Interesting question since their Public Affairs Manager Berry Friesen attends the of Healthcare For All PA’s forums…

The Daschle Problem

Tom Daschle was a bad choice for HHS from the beginning.  I came out against him on the basis of his qualifications to fundamentally change our healthcare system and he remains poorly equipped for that due to his involvement as a lobbyist for the industry.  His newly revealed ethical problems cast a longer shadow on his fitness for this office.  

If someone gave me a Lincoln Town Car and chauffer for my exclusive use I would know, or at least suspect, that this was an enormous perk for which taxes are due.  How stupid is Tom Daschle not to know this or not to inquire into its tax consequences?  This man was the Democratic Leader in the U.S. Senate for crying out loud.  He’s written, analyzed and voted on innumerable tax laws.

Unfortunately for the South Dakotan the legal burden of proof is always on the person to know the law.  It is irrelevant whether or not he knew the law even though most of us would have assumed a $200,000 perk was taxable.  This is the world of the Washington hubris when powerful people adopt a Leona Helmsley attitude that taxes are only for “the little people.”

Daschle is unqualified to be Health and Human Services Secretary because he was a lobbyist for that industry.  Barack Obama promised to rid his Administration of such lobbyists and conflicts of interest.  It hasn’t happened.  You simply cannot change the culture of Washington overnight but the President can go a long way by replacing Daschle with Dr. Howard Dean.

Update:  Daschle has withdrawn his name for consideration as HHS Secretary.

Healthcare: The Real Cause of the Economic Collapse

It is generally thought that home foreclosures are the heart of last year’s economic collapse.  Foreclosures soared as homeowners were no able to pay their mortgages and the predatory lenders responsible for these and the Wall Street types who packaged them into toxic securities have been the villains.  This isn’t entirely true however.  Though all these culprits are the vultures as portrayed the real villains are health insurance companies.  

A new study reveals that the underlying cause of these foreclosures was our broken healthcare system.  It was medical bills which triggered the foreclosures.  It was the tens of millions spent by the health insurance industry over decades to block civilized healthcare and triggers 50% of all bankruptcies in America.  The report was researched and written by Christopher Tarver Robertson, Richard Egelhof and Michael Hoke.  Here are some conclusions:

49% of all foreclosures are caused by medical bills

69% of those in foreclosure had serious medical problems in the two years prior to their defaults

33% of those studied had no health insurance (or a spouse), double the average

33.8% of the uninsured households blamed their foreclosure on medical problems

These victims were middle class Americans with full time jobs but no or inadequate health care coverage

This means that about one third of the foreclosures resulted directly from our failed healthcare system.  This was the trigger which sent the economy spiraling into depression.  Until we directly confront these foundational fissures our economy will continue cracking under the load of medical care.  Baby boomers like me are retiring and demand for medical care is spiraling upward at the same time our economy is going into the tank.

We must shore up our failing economy before it is too late.  This means saving homeowners from bankruptcy and foreclosure.  The surest method for that is complete, radical healthcare reform.  Some are favoring an incrementalist approach which involves changing rules and laws which allow insurance companies to deny coverage, care and treatment.  This is a band aid on a cancer and doesn’t solve the underlying law which they cannot replace:  corporations and companies are bound, by law, to act first for their owners and shareholders.  Not their customers.  None of these incrementalist approaches advanced by Healthcare for America Now solve this problem.  None of the rules they seek to change change this foundational fact:  shareholders and owners come first.  Changing that law derails our entire capitalist system and cannot be changed.

Therefore the incrementalist approach is doomed to failure.  You can pass all the laws you want saying insurance companies must provide medical care but they cannot and will not under the most basic law of business.  Repealing that undermines our entire system so it cannot be altered.  

The solution is to rid ourselves of the insurance industry.  Until the profit first motivation is removed people cannot receive adequate, comprehensive healthcare.  Take the profit completely out of who gets medical care, when and where.  When I call my doctor now I get in a line.  I cannot simply walk into an office and see my doctor.  When I call for an appointment I am put into line.  I get to see him when it is my turn.  The only exceptions to this are emergencies and trauma cases when everyone goes back in line for the direst cases.  Universal healthcare does not mean you will be in any lines you aren’t already in.  It does mean you will choose your provider and no bureaucrat will tell you what doctor, what lab, what clinic, what hospital you can visit for care.  It actually opens your choices to any provider unlike our current system where you are forced to use certain providers.  Single payer universal healthcare for all means the only people making your medical decisions are you and your doctor.  It means you get fully comprehensive coverage and care for less money.  It means everybody in and nobody out.  It means saving the economy, keeping people in their homes and extending the quality of life for every American.

State and local governments are being killed by healthcare costs much as homeowners.  Annual increases of 9% are crippling budgets resulting in layoffs for police, fire, school and anyone else in the public sector.  Cutting healthcare costs to 10% of payroll will save jobs and greatly eliminate the deficits facing our public officials.

Why are Ed Rendell, Dwight Evans, Todd Eachus and Keith McCall blocking this solution in Pennsylvania?  When you lose your job and your home remember who caused this meltdown and who blocked the solution.  Remember this when you vote.