Three people who were covered by a state-run health care
plan for lower-income adults that stopped being funded two weeks
ago began a lawsuit Monday to force Pennsylvania to re-establish
the program.
The lawsuit filed in Commonwealth Court alleges that money set
aside for the plan, called adultBasic, was unlawfully diverted
to other purposes, and is directly responsible for the plan's
end on Feb. 28. The suit, filed by Sheryl Sears of McKeesport,
Ronald Guiney of Butler and Florence Spanos of Pittsburgh, also
seeks a class-action order. More than 41,000 were covered under
adultBasic.
It names Gov. Tom Corbett, his budget secretary, the Treasury
Department, House Speaker Sam Smith and Senate President Pro
Tempore Joe Scarnati.
The plaintiffs' lawyer, Bill Caroselli, told reporters in a
conference call that the Legislature and the executive branch
had no legal power to end the program.
"It is not discretionary, and the Legislature and executive
branch must fund this program," Caroselli said.
The program was created by a 2001 law, which also calls for the
state to annually set aside up to 30 percent of money it
receives from its 1998 settlement with major cigarette
manufacturers. The state is scheduled to receive another
approximately $370 million in April.
Spokesmen for Smith and Scarnati, both Jefferson County
Republicans, said they had not seen the lawsuit, and a
spokeswoman for Corbett released a two-sentence statement in
response.
"The lawsuit is without merit and will be successfully defended
in court," the Corbett administration said. "The fiscal reality
is that adultBasic is not a financially sustainable program."
AdultBasic coverage ended amid partisan finger pointing over who
was to blame and the state government facing a projected
multibillion-dollar deficit.
Sears, 63, makes money babysitting, but lives alone and is
having trouble affording the new health care plan she's paying
for. That plan, called Special Care, is a subsidized plan run by
Highmark Blue Cross Blue Shield and costs Sears $162 per month,
compared with the $36 per month average adultBasic premium. To
fit it into her budget, she's putting off paying other bills.
"I don't know how long I'll be able to afford $162 a month," she
said.
In the meantime, Corbett has said the state doesn't have the
money to continue paying for adultBasic, and he instead proposed
diverting money from the tobacco settlement into the state's
main bank account, which pays for hundreds of programs.
The state's Blue Cross/Blue Shield insurers, who have paid for
the lion's share of adultBasic in recent years, have decided
against continuing to pay for it and the Legislature made no
move to extend it.
AdultBasic began in 2002 as a basic health insurance program for
low-income working adults who weren't poor enough to qualify for
Medicaid and weren't old enough to qualify for Medicare. It
didn't cover dental needs or prescription drugs, but it covered
the cost of major surgeries and is considered better coverage
than Special Care.
In 2005, the state's Blue Cross/Blue Shield insurers, which were
under scrutiny from then-Gov. Ed Rendell's administration for
the size of their surpluses, agreed to help finance adultBasic
for six years, ending Dec. 31, 2010.
Corbett, a Republican, and top GOP lawmakers claim that Rendell
bankrupted the program by keeping premiums too low, enrolling
too many people in it and relying too heavily on the
time-limited agreement with the Blues.
Rendell, a Democrat, has said that "there is no financial or
moral reason" that the four Blues insurers' commitment to
underwrite adultBasic should have expired. Their collective
surpluses stood at well over $6 billion on Sept. 30, according
to the state Insurance Department.