Community Legal Services of Philadelphia applauds the Corbett Administration for providing additional guidance and assistance to Pennsylvania adults who lost their adultBasic health insurance on March 1, 2011 in seeking health insurance coverage through the Medical Assistance program, Pennsylvania’s Medicaid program.

On April 14, 2011, the Pennsylvania Insurance Department sent out 8,300 letters to women between the ages of 18 and 44 who lost their adultBasic health insurance when the program ended. The letters advised women that they may qualify for SelectPlan for Women, a limited Medical Assistance program that provides gynecological care and other women’s health services. The letters also advised women as to how they could seek more comprehensive Medical Assistance benefits.

In the coming days, the six insurance companies that provided adultBasic health insurance before the program ended will send out letters to thousands of former adultBasic recipients. The letters will provide information as to how the recipients may seek Medical Assistance. While the Insurance Department previously sent letters about Medical Assistance to the recipients, the new letters will provide the most detailed information to date.

Those former recipients with characteristics that indicate that they may qualify for Medical Assistance will be referred to the Pennsylvania Department of Public Welfare, where a Medical Assistance application will be generated for them. Recipients will be sent notices asking them to provide the necessary documentation to demonstrate their eligibility, such as proof of certain countable resources like bank statements or retirement accounts.

Former recipients who may be eligible for Medical Assistance include women who have sought medical care for a pregnancy, women who are receiving treatment for breast and/or cervical cancer, and people who have a history of heavy adultBasic health insurance utilization. The Commonwealth offers Medical Assistance to several categories of low-income Pennsylvanians, including pregnant women, women in active treatment for breast or cervical cancer, and disabled persons.

The Insurance Department identified more than 20,000 former adultBasic recipients with characteristics that indicate that they may qualify for Medical Assistance. Community Legal Services expects that many of those recipients will qualify for Medical Assistance once they provide the necessary documentation to the Department of Public Welfare.

Pennsylvania’s adultBasic health insurance program provided health insurance to approximately 41,000 low-income adults until February 28, 2011. The program was funded with Tobacco Settlement Fund monies and charitable contributions from Pennsylvania’s Blue Cross/Blue Shield plans. Governor Corbett announced that the program would end on February 28 due to a lack of funding.

In February 2011, Community Legal Services contacted the Insurance Department and the Department of Public Welfare. Attorneys for Community Legal Services expressed their belief that, because the adultBasic and Medical Assistance programs were operated in concert, adultBasic recipients should be screened for Medical Assistance before the adultBasic program ended. The Insurance Department committed to sending more detailed letters about Medical Assistance eligibility to former adultBasic recipients. It also committed to working with the six insurance companies that provided adultBasic health insurance to seek paid health benefits claims data to identify recipients with characteristics that indicated that they may qualify for Medical Assistance.

Kristen Dama, Staff Attorney for Community Legal Services, stated, “We are extremely pleased that Governor Corbett’s Administration is taking steps to ensure that former adultBasic recipients with serious medical needs are not left without health insurance.”

Jonathan Stein, General Counsel for Community Legal Services, added, “By notifying former adultBasic recipients that they may be eligible for Medical Assistance, and by referring the likely eligible to the Department of Public Welfare, we expect that many thousands of otherwise-uninsured adults will be able to secure the health insurance and health care that they urgently need.”

Dechert LLP provided pro bono legal counsel to Community Legal Services in its discussions with the Insurance Department and the Department of Public Welfare.

Community Legal Services provides low-income Philadelphia residents with advice and representation in civil legal matters, while advocating for residents’ legal rights and conducting community education about legal issues that affect them. Advocates at Community Legal Services work to fight consumer fraud and predatory lending; prevent homelessness; ensure fair treatment in the workplace; and protect women, children, and the elderly.