Democratic leaders in Pennsylvania hope to double the number of residents who receive state-sponsored health insurance, known as adultBasic, but Republicans fear the costs may be too high.

The Pennsylvania House on Monday voted, 104-98, in favor of HB 1, to increase the number of individuals receiving adultBasic from 45,000 to 90,000.

Republican leaders in the Senate say they might oppose the effort. Carolyn Scanlan, president and CEO of the Hospital & Healthsystem Association of Pennsylvania, also expressed reservations.

Pennsylvania, like the nation, has seen the numbers of uninsured soar in the last year as the economy has declined, making a bad situation much worse.

AdultBasic is designed for people who earn too much to qualify for poverty programs such as Medicaid but can't afford insurance themselves.

An individual is eligible for adultBasic if he or she earns $21,600 or less; a family of four can earn $44,000 or less.

The program can't begin to meet the rising need. The waiting list, officials say, is growing by 20,000 a month and projects 270,000 as of today.

A year ago, it was at 96,000.

Ann Torregrossa, director of the Governor's Office of Health Care Reform, says the cost of expanding adultBasic - $130 million - will be paid with federal Medicaid funds available through a special waiver.

"The people that adultBasic services are the people that serve us - waitresses, grocery baggers, cabdrivers," Torregrossa said. "It's absolutely insane not to take advantage of the waiver. We can more than double the number of people we cover without spending one dollar more of state money."

Republicans, however, say the expansion will cost state taxpayers money. They also question the wisdom of expanding the program when the state faces a $3 billion budget shortfall.

$50,000 in medical bills

Charmaine Humphrey, 37, of Kensington, is on the waiting list.

She is homebound, unemployed, uninsured, and taking six medications daily to deal with five medical conditions, including fibromyalgia, which can cause chronic pain and inflammation.

As an Air Force medic, sales manager, and most recently executive assistant, she always had health insurance - until illnesses forced her to resign in 2007, she said.

She and her husband have been on the waiting list for a year.

They owe $50,000 in medical bills, she says. She pays $200 a month out of pocket at Walgreens for discount drugs, which are called in as a favor by her former doctor, whom she can no longer afford to see.

She hopes a three-week ear infection won't get worse and require her to see a specialist whom she cannot afford.

More modest in scope

Two previous efforts by Gov. Rendell to expand coverage of the uninsured have died in the legislature. This year's effort is more modest in scope - at its best only denting the waiting list.