News

July 29

Protest to save health plan held

Group wants Blue Cross to maintain coverage for low-income workers.

By Steve Mocarsky smocarsky@timesleader.com
Staff Writer

WILKES-BARRE – A handful of people gathered on Wednesday outside Blue Cross of Northeastern Pennsylvania offices, holding signs with slogans prodding the company to continue funding an insurance plan for low-income workers.

“This is part of a statewide action in an effort to tell our state legislators and Blue Cross that we can’t afford to lose adultBasic. It’s a critical low-cost health insurance program that’s serves almost 46,000 Pennsylvanians, including about 1,100 in Luzerne County,” said Athena Ford, a statewide organizer with the Pennsylvania Health Access Network – a coalition of organizations advocating for quality health insurance coverage that organized similar rallies statewide.

“These are some of the most vulnerable Pennsylvanians when it comes to obtaining health insurance,” Ford continued.

“They make less than 200 percent of the federal poverty line. Most of them make a little too much to qualify for Medicaid, but not enough to be able to afford the skyrocketing costs of health insurance, and so this is their only option,” Ford said.

Among those who attended the rally was Ann Marie, a 56-year-old Clarks Summit resident who declined to give her last name. She’s been on the adultBasic plan for about four years.

Without adultBasic, she said, “I just don’t know what I’ll do. I make under $10,000 a year. I looked at other plans and they’re way above what I could pay.”

The monthly premium is $36, and people who make less than $21,660 a year qualify for it. There are nearly 400,000 Pennsylvanians on the waiting list.

Ford said Blue Cross is a non-profit charitable organization and therefore receives “generous” tax breaks from the state.

“In return, they’re legally obligated to make charitable contributions. It’s the right thing to do to continue making a portion of those contributions to helping the most vulnerable people of our state get insurance,” she said, adding that the Blues have a combined nearly $6 billion surplus.

Ford provided a copy of a report released Wednesday by the Pennsylvania Budget and Policy Center titled "AdultBasic Sings the Blues," which examines adultBasic and the Blues's surpluses.

Blue Cross of NEPA spokeswoman Michelle Davidson said many of the tax breaks in existence 10 years ago are no longer in place.

“We’re proud to have this role in the community … to do what we can to help people in the community. But the taxes have shifted and the world has changed even in the last five years. We think adultBasic is a very important program. But realistically, we need other (health insurers) to join us in funding it,” she said.

Blue Cross of NEPA spokesman Anthony Matrisciano said the company received $55 million in tax exemptions over the last five years. During that same period, the company subsidized non-group plans by more than $133 million and its charitable foundation gave more than $6 million to area agencies helping low income un- and under-insured,

“So for the privilege of the $55 million tax break, we spent $140 million,” Davidson added.

As far as a seemingly large surplus, Matrisciano said insurers are required to keep a minimum surplus of twice the annual operating costs, referred to a risk-based capital level, or RBC, of 200 percent. Blue Cross of NEPA’s was 557 percent in December 2009.

Matrisciano referred to a Consumers Union report that suggested Blue Cross of Northeastern Pennsylvania’s RBC was “not too large and not too small.” at the end of 2009.

According to the report, which looked at 10 Blue companies nationwide, Blue Cross of NEPA’s RBC continuously declined from 1,051 percent in 2001 to 557 percent in 2009.

Davidson said other non-profit insurers such as Geisinger Health Plan also receive tax breaks and have surpluses but are not expected to contribute to fund adultBasic, which is unfair to the Blues’ customers and bad public policy.

Geisinger’s RBC at the end of 2009 was 405 percent, according to Geisinger Health Plan spokeswoman Lisa Hartman said that while Geisinger officials are “very concerned” about Pennsylvania’s uninsured residents, they believe Geisinger Health Plan “should not be involved in” the Community Health Reinvestment Plan.

“The agreement was developed for the Pennsylvania Blues. And while the agreement was not officially tied to the level of reserves built by the Blues, it was clearly based on their ability to support community health with the significant resources available to them,” Hartman said.

State Rep. Todd Eachus, the House Majority Leader from Butler Township, introduced legislation in April that would force the Blues to continue funding adultBasic until 2014 when federal healthcare reform should be fully implemented. The legislation has been in committee since then.

“We are not going to allow more than 40,000 Pennsylvanians to be dumped in the street, losing their insurance coverage. I will continue to endeavor to find a way to make sure that doesn’t happen. There are people whose very lives hinge on these programs,” Eachus said.

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