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(Revised and republished)

Yet another state, with yet another Republican Governor and legislature, is turning on its budget-cutting buzzsaw with nary a thought to the poor and sick who will be chewed up by it.

According to NPR, Pennsylvania is terminating its AdultBasic Insurance program as of February 28th, 2011.  It currently provides extremely low-cost health insurance coverage ($36/month) for 42,000 Pennsylvanians who are poor but not poor enough to be covered by Medicaid. Tomorrow it will cease to exist.

Why is it being axed? Because the state has a $4 billion dollar budget shortfall and, as one Republican State Senator in Pennsylvania says,

our governor has said he will not raise any taxes...

Sound familiar?  

The AdultBasic program cost $166 million in 2010.  Let's do a bit of simple math. There are about 12,000,000 people in the state, so on a per capita basis that works out to $14 per person.

Let's assume the people of Pennsylvania are Scrooge-like monsters too poor to assume that burden. What would it take to fully fund the program on the backs of the poor who are its beneficiaries? Premiums would have to rise to $329 per month to fully fund a program for 42,000 people that costs $166 million. A large amount, and likely unpayable by many in the program. But has the Governor even proposed such a draconian solution, or been willing to compromise in any fashion? Not according to the article. Instead, the Governor insists on eliminating the program. Of course, it's not his fault: he is laying the blame on the previous administration:

The Corbett administration has said Rendell didn't do enough to secure funding.

and since

our governor has said he will not raise any taxes...

he is powerless, completely powerless, to do anything.  But make no mistake about it.  This is in fact a cold, calculating move, taken in the name of fiscal responsibility but executed on the altar of Galt and Greed.

In the 1960's President Johnson declared a War on Poverty. It didn't work; the poor are still among us. In the 2010's, Republicans have decided to take a different approach by declaring instead a War on the Poor. In state after state programs that assist the neediest amongst us are being slashed because

our governor has said he will not raise any taxes...

Let's face it. There is absolutely no reason to terminate this Pennsylvania program. Other than, that is, the incredible callousness of a Republican governor and his fiscal chickenhawk compadres in the legislature. A compromise that increased premiums somewhat along with tiny additional per capita expenditures would be all that it would take to save many of the 42,000 enrolled the psychological agony, the physical pain, and the possibility of bankruptcy or even death, that will entail when the program terminates:

Paula Michele Boyle is a survivor of Hodgkin's lymphoma, and Tom Boyle had prostate cancer. Both require significant followup care and testing. She has been on adultBasic since the program began, and her husband has been on it for the past five years...

We were in shock over this," Boyle says. "What are we going to do now? We need doctor visits and testing."...

Boyle called a private insurer but was told that because she had Hodgkin's lymphoma, the company would not sell her health insurance at any cost. Her husband can purchase insurance for $1,000 each month.

We're kind of scrounging, thinking we may have to give up our home just so that we can pay a high premium," she says. After 19 years in the same house, she says, that would be a painful decision.

What about the statewide federal high-risk pools set up by the new Health Care law, the PPACA?  In Pennsylvania, a policy would cost $283/month, which is a far cry from $36/month, but an even farther cry from $1000/month or no insurance whatsoever.  Alas

Pennsylvania's acting insurance commissioner, Michael Consedine, sent a letter to Kathleen Sebelius, secretary of the Department of Health and Human Services, requesting that the waiting period be waived for adultBasic subscribers who want to join the pools. He also requested that HHS reallocate some of the funding for other states that is not being used to expand the Pennsylvania pool. Sebelius rejected the proposal.

Nice spin. Sebelius didn't really reject the proposal. She couldn't accept the proposal because doing so would be against the law. The PPACA insists on a person having gone six months without insurance before they can become eligible.  There's nothing Secretary Sebelius can do about something that Congress has ordained from on high. After all, you wouldn't want a President and his cabinet to be able to torture people in violation of the Constitution, laws, signed treaties and basic human decency ignore the rule of law, would you?

Anyway, the high-risk pools only apply to those who have pre-existing conditions. It won't cover the presumably large percentage of the 42,000 in the AdultBasic program who simply need some kind of affordable insurance, even if a waiver were possible.

In 1903 the poem The New Colossus was engraved on the Statue of Liberty. It reads, in part

Give me your tired, your poor
Your huddled masses yearning to breathe free

If Republican Governors, Congresspeople, US Senators and State Representatives have their way, it will be replaced shortly with a slightly altered engraving:

Give me your tired, your poor
Your huddled masses yearning for medical treatment
And I will throw them under a bus.

Wisconsin has proved that it is possible to fight back. But fighting back means fighting back in lots of places -- against moves that target the most vulnerable among us, as well as moves against those of us who are healthy enough to march in blizzards in 17 degree weather and have jobs that provide insurance.

Where are the tens of thousands marching on Harrisburg?

(Revised and republished from Wednesday, at which time the diary kind of got lost in the din of major events of the day. I'm hoping this time it will get a bit more readership, although there doesn't seem to be any hope that the program can be saved)

Originally posted to jpmassar on Sun Feb 27, 2011 at 12:58 PM PST.

Also republished by Single Payer: The Fight for Medicare for All, DKos Pennsylvania, and SFKossacks.

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