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Health insurance provision declines in Pennsylvania

So here's a simple question for you as a fantasy decision-maker in charge of a state's finances. Let's say you go to court against Big Tobacco and come out with a big win. Because the court finally agreed to accept the medical evidence, Big Tobacco was ordered to pay money into a massive settlement fund. Every year, this pays out a big chunk of change to your state. What do you want to spend it on? It could be education except you really want to fire all the bad teachers first. Then you can use the extra money to pay higher salaries to attract better people into teaching and raise education standards. Ah, but that's going to provoke a fight with the unions, so we'd better look for something less controversial. What about health? This would be ideal politics. The tobacco industry has made so many ill, it's only right its money should be used to improve health care for all. Except how is that going to be done? Even a big lump of change gets lost in the total cost of running health care in a state. . .

Pennsylvania decided to use part of the money to fund adultBasic. This was an outreach plan for adults who would otherwise fall through the cracks. Their income is too great to qualify for Medicaid, but they can't afford the premium rates for a private plan. The way it worked was simplicity itself. The state funded its own health plan. The actual cost per person was $600 per month, but the state only charged each person $36. The total cost of this plan in 2010 was $166 million. To give you an idea of the popularity of the plan, the state was subsidizing some 40,000 people with half-million people on the waiting list. Remember, there are some 50 million people without any form of insurance across the country. It should not surprise you there were so many people who felt they met the entry requirements for adultBasic in one state.

However, in February, the Pennsylvanian government announced it was looking at a big deficit, so Governor Tom Corbett looked around for cuts. Presumably feeling the 40,000 enrolled in the plan were freeloaders, he ordered the plan shut down immediately. Big Tobacco's money now flows directly into the state's coffers and is mixed in with general revenue. Curiously, the state has now discovered it will have a surplus of more than $750 million in the current year. It's remarkable how quickly the fortunes of a state can turn around. One of the immediate consequences has been a 30% increase in the number of people walking into ERs around the state. This adds significantly to the cost of running the health care services. Ironically, this additional cost alone may be more than the state was spending on adultBasic.

The Democrats have been frustrated at their failure to get adultBasic reinstated. It was one of the few state-funded health insurance plans for the low-income group. Yet a Republican governor will always get political traction out of cutting such a high-profile example of "big government". Adult Americans should pay for cover out of their own pockets and not look to the state to provide cheap health insurance (even with money from the tobacco industry).


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