Health coverage at risk for working poor in Pa.

An affordable health-insurance program for low-income working people that was started by Gov. Tom Ridge and expanded under Gov. Rendell is projected to run out of money within weeks after Gov.-elect Corbett takes office, administration officials said.

Contractual obligations mean that insurance-termination notices may need to go to tens of thousands of subscribers in the program, known as adultBasic, even before the new governor is sworn in, if more than $50 million is not found before then, they said.

As attorney general, Corbett joined a lawsuit seeking to overturn President Obama's health-care overhaul. The opposition was based on the mandate that individuals and many businesses sign up or pay a fine, said Kevin Harley, a spokesman for the transition. The governor-elect said during the campaign that he supported plans to continue funding the state program at least through the fiscal year that ends June 30.

The transition team will examine any earlier shortfall "in great detail," Harley said.

"I don't think the new governor wants to come into office and the first thing to happen is to have 43,000 people lose their health insurance," said Sharon Ward, director of the Pennsylvania Budget and Policy Center, a nonpartisan but liberal-leaning group in Harrisburg.

Nearly 464,000 people are on the adultBasic waiting list.

"I believe there will be a good-faith effort to find a new solution to this," Ward said.

Both Ward and departing administration officials said the options may be limited, particularly given the time frame.

The legislature and governor could allocate money from the general treasury or divert more from the tobacco settlement, which already pays for part of the program. But the state already faces a projected $4 billion deficit next fiscal year. The Senate's last scheduled day is Wednesday, while the House has already gone home.

The other likely possibility would be additional contributions from the state's four Blue Cross/Blue Shield plans, which currently pay for most of the program. But lower-than-projected contributions this year from two of them - Highmark and Independence Blue Cross - are partly responsible for the shortfall, administration officials said, and spokesmen for both said they considered their obligations fulfilled.

The possibility of adultBasic's demise "terrifies" Denise Lohr, 56, owner of a pet-sitting business in Pittsburgh who spent two uninsured years on the waiting list before being accepted in 2006.

"I would probably be an invalid," said Lohr, who had spinal fusion six weeks ago and a hip replacement last year.

AdultBasic is no-frills. It does not cover prescriptions, for example, which Lohr estimates cost her $1,500 a year.

But the standard, $36-a-month premium is affordable on her $17,000-a-year income, which is too much for Medicaid and not enough for the private insurance policies that she priced at $300 a month for rock bottom.

For eight years, adultBasic has been Pennsylvania's main attempt to make health insurance affordable for low-income working people, supported - to a greater or lesser extent - by Republicans and Democrats in the legislature and governor's mansion.

Funding has see-sawed, however, as has enrollment, which is 42,625 this month, the state said Tuesday. The waiting list, meanwhile, soared during the recession.

AdultBasic was enacted in June 2001 under Gov. Ridge and launched in July 2002 under Gov. Mark Schweiker - the former lieutenant governor, also a Republican, moved up when President Bush named Ridge homeland security advisor after the Sept. 11 attacks - and was funded using money from the state's share of the tobacco settlement, an amount that fluctuates from year to year.

Gov. Rendell once had hopes of doubling enrollment to 100,000 - still less than one-quarter of the waiting list - but could not get approval for funding from lawmakers.

In 2005, he announced a coup: the state's four Blue Cross/Blue Shield companies - nonprofits that were under fire for accumulating large surpluses - had voluntarily agreed to pay quarterly into a fund to support the program according to a formula that was based on revenues minus certain expenses and losses.

Although the agreement allowed for only a small expansion, the Blues became the primary funding source for adultBasic. The pact was set to expire Dec. 31, 2010, around the time a new administration would take charge - and halfway through the state's fiscal year.

Key elements of Obama's health-care plan are scheduled to take effect in 2014.

The Pennsylvania House approved a bill last year that would have extended the agreement, but the bill did not pass the Senate. Instead, the Republican majority negotiated another voluntary agreement with the Blues, for a hard $51 million - half of what senators said they paid last year under the formula - for the first six months of 2011.

That was $26 million less than the administration said was needed even with attrition and no more enrollment, said Budget Secretary Mary Soderberg, adding that Rendell administration officials continued pushing for more funding without success.

"Rendell will likely blame the Senate Republicans for tensions in the Gaza Strip in his remaining few weeks," countered Drew Crompton, a lawyer for the GOP caucus, saying in an e-mail that the administration must have increased costs.

Meanwhile, contributions during calendar 2010 - part of which are normally held over for the next fiscal year - have come in $16 million below projections from Independence Blue Cross and $13 million below from Highmark, Soderberg said. She said both companies calculated their contributions differently, or timed them differently, than before.

Both companies said they had paid in full.

"The important question is: What is going to happen moving forward?" said Elizabeth Williams, a spokeswoman for Independence Blue Cross, which she said spent $424 million supporting adultBasic and other social programs between 2005 and 2009. "How is Pennsylvania going to identify sustainable funding for adultBasic . . .?"

Said Ward, of the nonpartisan budget center: "Gov. Corbett said he is worried about the people in Pennsylvania who have insurance and want to keep their insurance. This will be the first test of that commitment."