Pennsylvania Uses Tobacco Money To Begin Health Benefits Program for Low-Income, Uninsured Adults

Pennsylvania on July 1 will begin a program to provide basic health coverage to about 40,000 low-income adults using $76 million from the state's portion of the national tobacco settlement, the Philadelphia Inquirer reports. The program, adultBasic, will be available to uninsured residents ages 19 to 64 who have lived in Pennsylvania for at least 90 days and have annual incomes up to 200% of the federal poverty level, or $17,720 for an individual and $23,880 for a couple. Participants in adultBasic will pay a $30 monthly premium to receive physician, hospital and emergency coverage from private health plans. They will also pay copayments of $5 to see a doctor, $10 to see a medical specialist and $25 for treatment in an emergency room. The state has contracted with the following health plans to provide coverage: Keystone Health Plan East in greater Philadelphia; Capital Blue Cross/Pennsylvania Blue Shield in Central Pennsylvania; Highmark/Western Caring Foundation in Western Pennsylvania; and First Priority Health in Northeast Pennsylvania. The state Insurance Department will reimburse the health plans on a per-patient monthly rate. Gov. Mark Schweiker (R) said, "I think it's important for Pennsylvanians to understand that this is real insurance. This isn't some government-run program that is long on promises and short on coverage." The state estimates about 300,000 residents would be eligible for the program; however, the program will only be able to cover 40,000 of them (Loyd, Philadelphia Inquirer, 4/25).