Pennsylvania health insurance lifesaver going away thanks to...you know who

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    Jan 15, 2011 12:29 AM GMT

    http://www.pennlive.com/midstate/index.ssf/2011/01/pennsylvania_health_insurance.htmlPennsylvania appears headed for the largest one-day loss of health insurance in its history.

    The state-subsidized adultBasic program, which covers 42,000 low-income people, will run out of money at the end of February.

    Gov.-elect Tom Corbett plans to let it end. He’ll offer adultBasic users a different program — one that advocates for the uninsured say costs four times more and isn’t nearly as good.

    Corbett, a Republican, says the state can’t afford to continue adultBasic with an expected $4 billion deficit in the next budget.

    For the last six years, much adultBasic funding has come from the state’s four Blue Cross-Blue Shield plans. The agreement expired at the end of 2010.

    Advocates for the uninsured want Corbett to require the Blues to kick in money to at least temporarily continue adultBasic.

    They say the Blues have a combined surplus of $5.6 billion that’s substantially bigger than in 2005.

    “We realize the deficit situation for the commonwealth, but the Blues are certainly not in a deficit, and are really obligated, ethically, morally to make a sustainable contribution,” said Laval Miller-Wilson, executive director of the Pennsylvania Health Law Project.

    He acknowledged that additional money from the state and other sources would be needed to continue adultBasic, which cost $163 million last year.
    ...
    Beyond the 41,953 people covered by adultBasic, the program had a waiting list of 478,785 in December, up from 448,515 in October.
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    Jan 15, 2011 12:36 AM GMT
    And guess who Tom Corbett (R) (new governor) blames for this? The outgoing Rendell who tried his hardest to get a balanced budget with a Marcellus Shale natural gas drilling tax through, and got blocked by the Legislature in Harrisburg.

    Doesn't matter that 63% of those polled in PA agree to a Marcellus Shale tax:
    http://www.timesleader.com/news/Poll_says_Pa__voters_support_Marcellus_shale_gas_tax_01-07-2011.html

    PA is the only state that doesn't have a tax on natural gas drilling.

    http://www.pennbpc.org/fact-check-severance-taxes-and-marcellus-shaleIsn’t the industry paying hundreds of millions in taxes already?

    No. In 2008, oil and gas income tax revenue accounted for $38.8 million, according to the Pennsylvania Department of Revenue. Much of the equipment and supplies purchased by the industry are exempt from sales tax under Pennsylvania’s manufacturing exemption, and companies don’t pay property taxes on gas reserves. The industry is even trying to get an exemption from hotel taxes on rooms it rents for out-of-state workers.


    And don't get me started on the Blues again:
    7c9e0e5cf95a8604502fb18044c220b7-785x389
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    Jan 15, 2011 1:20 AM GMT
    SB, it's so good to hear that your idea of good state governance is to get rid of state-subsidied medical insurance for low income people. And we all know your animosity against the federal version.
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    Jan 15, 2011 1:38 AM GMT
    These are people who don't qualify for Medicaid (at least until 2014 when the qualifications go up). And CHIP is for children.

    It's called the adultBasic program for a reason.
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    Jan 15, 2011 1:41 AM GMT
    Well lets remember that the Tbaggers put him into office, and as I recall a large percentage of the baggers are SS recipients. Now they've gotten what they pushed for and they too will suffer for voting against their own interests. The Koch brothers money paying for and pushing the baggers every step of the way.

    Funny sheeples these baggers, kinda like one of their own, who was so outspoken and violent against the Health Care Bill, that he finally pissed off the wrong guy who punched him, the bagger ended up in the hospital and over the next several days went back out begging for help to cover his hospital bill because he had no Health Coverage. Yep !!! them baggers are doing themselves and everyone else a lot of favors aren't they.
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    Jan 15, 2011 2:00 AM GMT
    An adult must meet all of the following requirements to be enrolled in adultBasic:

    * must be between 19 and 65 years of age;
    * must be a resident of Pennsylvania for 90 days prior to the date of enrollment;
    * must be uninsured for at least 90 days prior to the date of enrollment, except if uninsured as a direct result of no longer working;
    * must be a U.S. citizen, permanent/resident alien, or refugee;
    * must not be covered by any other health insurance plan, self-insured plan, or self-funded plan;
    * must not be eligible for or covered by Medical Assistance or Medicare;

    * must meet the family size and income guidelines listed below.

    adultBasic Family Size and Income Requirements

    (After earned income and dependent care deductions)
    Family size Between ages 19 and 65

    1
    $21,660*
    2
    $29,140*
    3
    $36,620*
    4
    $44,100*
    5
    $51,580*
    6
    $59,060*
    7
    $66,540*
    8
    $74,020*
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    Jan 15, 2011 2:16 AM GMT
    I'm not seeing why the blame shouldn't be placed on Rendell. Why should private health insurers be forced to pay for a public insurance plan? What possible relevance do the surpluses of the "Blues" have to do with whether or not they should continue paying into this fund?

    Look at how the tobacco settlement money was used to pay for other things. This was a program that didn't exist pre 2005, Did people just die before that? This is one of the problems with entitlement programs. Once you put them in, they're so difficult to restructure or remove. People assume that once a subsidy, always a subsidy - and worse the funds that could have been used were redirected by the previous administration leaving the current one with effectively a "time bomb" that the Democrats are now blaming them for.
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    Jan 15, 2011 2:24 AM GMT
    According to Kaiser Family Foundation's Survey of Employer-Sponsored Health Benefits for 1999 to 2009, the average annual cost of health insurance coverage, as part of a group plan, is:

    * Individual: $4,824
    * Family: $13,375

    So you want an individual who earns $21,660 to pay close to 25% of his income for medical insurance.

    http://www.focuscenpa.org/Regional_Information-Cost_of_Living.aspxOverall: total Central Pennsylvania region counties’ and overall U.S. cost of living was weighted subjectively as follows: housing - 30%, food and groceries - 15%, transportation - 10%, utilities - 6%, healthcare - 7% and miscellaneous expenses (such as clothing, services and entertainment) - 32%. State and local taxes are not included in any category.

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    Jan 15, 2011 2:31 AM GMT
    riddler78 saidI'm not seeing why the blame shouldn't be placed on Rendell. Why should private health insurers be forced to pay for a public insurance plan? What possible relevance do the surpluses of the "Blues" have to do with whether or not they should continue paying into this fund?


    http://www.post-gazette.com/pg/10230/1080688-192.stmEfficiency is every business's goal, but with a surplus of $3.4 billion, does Highmark really need to take employment out of Pennsylvania and give it to India? The company, after all, must maintain a charitable mission to keep its nonprofit status in the eyes of the state, which confers certain tax breaks. The insurer does spend significant revenue on charity. In 2005, for instance, Highmark and the state's three other Blue Cross Blue Shield providers pledged $1 billion for the Children's Health Insurance Program and adultBasic, which helps low-income adults afford health insurance. Those funds are still being paid.


    This article's main subject is how Highmark is shuttling jobs to India via Accenture.

    And, as I said, Rendell had plans for a fairly balanced budget, until the Republicans killed the Marcellus Shale gas drilling tax, which, as I quoted above, 63% of polled Pennsylvanians want.
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    Jan 15, 2011 2:48 AM GMT
    adultBasic%20enrollment%20and%20waiting%
    http://www.pahealthaccess.org/blog/philadelphia-inquirer-health-coverage-risk-working-poor-pa
    Gov. Ridge, a Republican, started adultBasic in 2002, using money from the state's share of the tobacco settlement, an amount that fluctuates from year to year.

    Gov. Rendell once had hopes of doubling enrollment to 100,000 - still less than one-quarter of the waiting list - but could not get approval for funding from lawmakers.

    In 2005, he announced a coup: the state's four Blue Cross/Blue Shield companies - nonprofits that were under fire for accumulating large surpluses - had voluntarily agreed to pay quarterly into a fund to support the program according to a formula that was based on revenues minus certain expenses and losses.

    Although the agreement allowed for only a small expansion, the Blues became the primary funding source for adultBasic. The pact was set to expire Dec. 31, 2010, around the time a new administration would take charge - and halfway through the state's fiscal year.

    Key elements of Obama's health-care plan are scheduled to take effect in 2014.

    The Pennsylvania House approved a bill last year that would have extended the agreement, but the bill did not pass the Senate. Instead, the Republican majority negotiated another voluntary agreement with the Blues, for a hard $51 million - half of what senators said they paid last year under the formula - for the first six months of 2011.

    That was $26 million less than the administration said was needed even with attrition and no more enrollment, said Budget Secretary Mary Soderberg, adding that Rendell administration officials continued pushing for more funding without success.

    "Rendell will likely blame the Senate Republicans for tensions in the Gaza Strip in his remaining few weeks," countered Drew Crompton, a lawyer for the GOP caucus, saying in an e-mail that the administration must have increased costs.

    Meanwhile, contributions during calendar 2010 - part of which are normally held over for the next fiscal year - have come in $16 million below projections from Independence Blue Cross and $13 million below from Highmark, Soderberg said. She said both companies calculated their contributions differently, or timed them differently, than before.

    Both companies said they had paid in full.

    "The important question is: What is going to happen moving forward?" said Elizabeth Williams, a spokeswoman for Independence Blue Cross, which she said spent $424 million supporting adultBasic and other social programs between 2005 and 2009. "How is Pennsylvania going to identify sustainable funding for adultBasic . . .?"

    Said Ward, of the nonpartisan budget center: "Gov. Corbett said he is worried about the people in Pennsylvania who have insurance and want to keep their insurance. This will be the first test of that commitment."
  • musclmed

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    Jan 15, 2011 3:11 AM GMT
    southbeach1500 said
    q1w2e3 said
    *
    People at those minimums can afford to purchase their own health insurance.

    They won't eat like royalty - or members of Congress - but chances are, they're also on food stamps anyway. icon_wink.gif


    uh a no.

    The problem is more than insurance.


    q1w2e3, i admit, at those incomes you cannot afford insurance. Because for the most part the people at those incomes in general would skip that sort of thing, unless they are sick.

    Point is, people who end up signing up or requiring insurance are the sick.

    Therefore is it really "insurance" they are not utilizing insurance. Its HEALTHCARE. Which is a different thing.

    Since there is a paucity of well people the insurance cost is high. This is a ponzy scheme with only one end. The insurance will cost more and more, and the system will eventually reset.

    When i was small, i had a renal problem. My parents had to pay out of pocket. There was blue cross ( catastrophic) thats it.

    This idea of going to the doctor and everything is covered has destroyed medicine and inflated the costs. What it leads to is unnecessy testing and fluff. 1/2 of my day is fluff and silly nonsense to jump through hoops so my staff can get paid.

    No one ever bothered to ask the MD's who actually see patients for a solution. The AMA ( a conglomerate of politicians and academics) worsened the health-care debate.

    Tomorrow you can increase access to healthcare. By allowing any patient who is under insured to be seen on a sliding scale based on income. In return any healthcare provider can deduct that service as a tax deduction based on medicare billing. In return they are also seen with a arbitration agreement for liability.

    No bureaucracy, no healthcare czar. They get to come to the same office/er/hospital as everyone else.



    The system needs to right itself. In the short term utilize what we have
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    Jan 15, 2011 3:20 AM GMT
    Um, you hit the nail on the problem...

    musclmedSince there is a paucity of well people the insurance cost is high. This is a ponzy scheme with only one end. The insurance will cost more and more, and the system will eventually reset.


    Hence all people, well or not, need to pay into the system.
    Hence the individual mandate. Or until we get universal health care funded by ALL taxpayers, according to what they can pay into the system.

    musclmedTomorrow you can increase access to healthcare. By allowing any patient who is under insured to be seen on a sliding scale based on income. In return any healthcare provider can deduct that service as a tax deduction based on medicare billing. In return they are also seen with a arbitration agreement for liability.


    I already do my part...I see people for free in the local clinic. We routinely waive copays already for certain people. And we've practically given up on trying to get people to pay what they owe us because it would mean that we'll stop seeing them.

    The problem is that I don't control other costs--medications, hospital care, the technology that goes into what is healthcare today. My medical advice is cheap relative to all that. Heck, I practically give it up for free when we take phone calls from patients who don't want to come in to see me in the office but just want their lab results!


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    Jan 15, 2011 3:22 AM GMT
    southbeach1500 said
    q1w2e3 saidAccording to Kaiser Family Foundation's Survey of Employer-Sponsored Health Benefits for 1999 to 2009, the average annual cost of health insurance coverage, as part of a group plan, is:

    * Individual: $4,824
    * Family: $13,375

    So you want an individual who earns $21,660 to pay close to 25% of his income for medical insurance.


    Sure.

    People living in NYC pay 50% of what they earn to the government in the form of Federal, state and local income taxes and a crushing sales tax.

    You liberals never seem to complain about that... icon_rolleyes.gif


    That's why it's called a progressive taxing scheme. Not everybody pays 50%.
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    Jan 15, 2011 3:42 AM GMT
    southbeach1500 saidblockquote>

    True to a certain extent. I've had my own purchased health insurance since I was 23. But the problem with that is in just FIVE years it went from $69 a month to $174 a month. I won't be able to afford this if it continues to hike exponentially by the time I'm 30 if I don't get into two higher tier brackets of income.

    So to modify your statement, you are correct for people under 30.
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    Jan 15, 2011 3:43 AM GMT
    southbeach1500 saidPeople at those minimums can afford to purchase their own health insurance.


    True to a certain extent. I've had my own purchased health insurance since I was 23. But the problem with that is in just FIVE years it went from $69 a month to $174 a month. I won't be able to afford this if it continues to hike exponentially by the time I'm 30 if I don't get into two higher tier brackets of income.

    So to modify your statement, you are correct for people under 30.
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    Jan 15, 2011 3:52 AM GMT
    But we wouldn't want Jake to get rid of his "miscellaneous" expenditures, now would we? No new clothes, no electronic keyboards for his music, no hair gel (if his hair is long enough, say). That's just wrong. icon_lol.gif
  • musclmed

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    Jan 15, 2011 3:59 AM GMT
    southbeach1500 said
    q1w2e3 said
    southbeach1500 said
    q1w2e3 said


    You'd be amazed at how quickly you get near 50% on a $40k/yr income in NYC.

    My point is.... you liberals NEVER complain about more taxes. You never meet a tax that you don't think is "reasonable" and that kind of thinking is what has got PA into the sad state of affairs it's in (along with NY, IL, CA....)

    PA, like CA and IL is quickly coming to the point of collapse due to the idea of the "nanny state" and we're gonna see more of this in the months and year(s) to come unless a major change in course is made NOW.

    So once again, I applaud the Governor-elect of PA in taking this action.


    I agree the problem needs solving but the solution is not within government.

    That being said there within some of the Underinsured some who would choose to not be. At the expense of us all.

    Case/point i see some IM patients when docs' are off. A patient came today with a respiratory problem. Over the phone he was told by a triage nurse to go to the ER, way too sick for the office.

    Our organization for "self pay" will take a 65 dollar deposit. And eventually get a bill. (cost minus 20%) for billing.

    He decided not to go to the ER, but to showup anyway.

    He got treated at considerable time consumption to the office.

    but when questioned he said he didnt feel like paying a ER. *Mercedes benz keyz on the counter.
    ( oh and btw, he had just got back from a vacation in Mexico)

    Some people need charity, some are bottom feeders who take advantage of others. In the patient population I practice in very few are poor, but some of the uninsured are that way by choice.

    The only way to help people with charity is to put it in the physician hands.

    If you make it a psuedo "right" , it will be watered down to worthless care. Then people will search out to buy higher tiered care.

    We need to cut out the vampires of the HMO/ Insurers.

    These creations of the "HMO and taking health care deductible tax credits from the private person and putting it on the Corporation has created this mess. It needs to get back to the way things used to be pay as you go, insurance for catastrophic hospital costs.


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    Jan 15, 2011 4:15 AM GMT
    I see your point about the insurance companies. But they are here to stay until there is enough political will to get rid of them for good.
    Adultbasic is no-frills insurance, btw.
    And I also see your point about bottom feeders( we got some too).
    Catastrophic insurance is murky though. Dialysis, for example, straddles that divide between routine and catastrophic care. Most assistance programs treat it like dirt.
  • musclmed

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    Jan 15, 2011 4:31 AM GMT
    q1w2e3 saidI see your point about the insurance companies. But they are here to stay until there is enough political will to get rid of them for good.
    Adultbasic is no-frills insurance, btw.
    And I also see your point about bottom feeders( we got some too).
    Catastrophic insurance is murky though. Dialysis, for example, straddles that divide between routine and catastrophic care. Most assistance programs treat it like dirt.


    Hemodialysis , you can use as and example . In the UK is renal replacement offered to over 65, 70?

    Shockingly if you delve deeper there is a culture of not offering this.

    Whats going to happen in a Obamacare world. You think Dialysis is a sacred cow?



    What they need to do is get healthy people on the rolls.

    Giving a tax break to corporations for coverage is not fair. And the regular folks should be able to use pretax income to pay for insurance or healthcare costs.

    What you have now is that healthy people wait until something happens. You can make it part of a health/retirment slushfund.
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    Jan 15, 2011 4:00 PM GMT
    Yes, when that industry actually does not promote the optimal health of the population. Is there a role for health insurance companies? Yes, and it's as a supplement for people who can actually pay, like in the Netherlands.

    Healthcare should not be a business for profit. The instruments of healthcare can be made by industry, but the providing of it should trump any business concern.

    Same thing for tobacco companies.

    If by 100% un-American you mean to get rid of industries that kill, then sure, I don't care what epithets you call me, but get rid of that industry.

    SB, I've tried civility, I've never insulted you. You're on my permanent block list.
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    Jan 15, 2011 5:59 PM GMT
    q1w2e3 saidSB, it's so good to hear that your idea of good state governance is to get rid of state-subsidied medical insurance for low income people. And we all know your animosity against the federal version.


    You better start donating!


    p.s. Putting someone on a block list whom you disagree with is quite puerile.
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    Jan 15, 2011 6:04 PM GMT
    mocktwinkie said
    q1w2e3 saidSB, it's so good to hear that your idea of good state governance is to get rid of state-subsidied medical insurance for low income people. And we all know your animosity against the federal version.


    You better start donating!


    p.s. Putting someone on a block list whom you disagree with is quite puerile.


    Mock, Q is talking about civility in regards to blocking, not difference in opinion. As well, did you not read about some of what Q donated in time and unpaid work?