Falling Through the Cracks: Six Months After the End of adultBasic

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Where Are They Now?

Six months after the end of the state’s adultBasic program, few former enrollees have been able to access the options offered them when the program ended. Fewer than 40% of the 37,588 individuals who lost their insurance at the end of February have enrolled in Medical Assistance or Special Care, a low-cost, limited benefit product offered by Pennsylvania’s Blue Cross/Blue Shield plans. While some of the remaining 23,261 individuals may have found another option, many of them have simply fallen through the cracks and likely remain uninsured.

Less than 40% of Former adultBasic Enrollees are Known to Currently Have Health Coverage

Source. Data requested by the Office of Senator Mike Stack from Pennsylvania Departments of Public Welfare and Insurance (Aug 2011 data).

As of August 24, 2011, only 12,814 former adultBasic participants had enrolled in Special Care — about 34% of those enrolled in adultBasic when the program closed in 2011. While offered as a viable option for adultBasic enrollees, Special Care carried a monthly premium three to four times that of adultBasic, 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 in February 2011. 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.

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