A patient with a broken leg may be satisfied to walk with the help of a cast and a cane for a few months, but the goal of his medical treatment is a leg that's healed and healthy for the long term.

Likewise, the state's adultBasic health insurance program needs more than a short-term fix.

Pennsylvania's Blue Cross/Blue Shield providers -- including the Highmark health plan in Western Pennsylvania -- agreed in 2005 to contribute to adultBasic, which currently covers 45,927 uninsured adults who aren't poor enough for Medicaid or old enough for Medicare. The Blues have paid nearly $700 million to the successful program, but the agreement is set to expire at the end of the year. If it isn't extended, thousands of the working poor -- 4,655 of them in Allegheny County -- either will have to go without coverage or buy far-more expensive plans.

Right now adultBasic customers pay $36 a month and cannot be denied based on pre-existing conditions. So far, the insurance companies are willing to commit to only a six-month extension. What's really needed, though, is a deal that will keep this affordable care available until 2014, when it can be replaced under provisions of the new federal health care law.

When the Blues agreed to start paying for adultBasic in the first place, the insurers were under intense state scrutiny because of the large surpluses they were accruing. According to a report released Wednesday by the Pennsylvania Budget and Policy Center, a research organization, the surpluses have grown, to $5.6 billion last year.

Gov. Ed Rendell was instrumental in negotiating the six-year agreement, but he is winding up his second term. The candidates hoping to succeed him are divided, with Democrat Dan Onorato seeking the longer commitment but Republican Tom Corbett content with a six-month extension. The Legislature has shown little interest in moving a bill that would mandate payments through 2013.

Like a patient waiting in the emergency room, Pennsylvanians are going to have to speak up and demand attention from the Blues because they need this stopgap treatment until there's a permanent cure.

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