HARRISBURG — The number of Pennsylvania adults on a waiting list for state-subsidized health insurance has reached an all-time high, a state Insurance Department spokeswoman said Tuesday.

The waiting list for the adultBasic insurance program had 145,800 adults as of the beginning of December, agency spokeswoman Rosanne Placey said. That reflects an increase of about 15,000 since November — a record-high monthly spike, she said.

"The situation isn't getting any better as it relates to the uninsured," Placey said. "It's only getting worse, and people come to us every day asking us, 'When can we get off the waiting list?"'

The waiting list has been at six figures for the past several months, Placey said.

The program currently serves 46,543 working Pennsylvanians who lack health insurance, but whose incomes are too high to qualify them for federal Medicaid health benefits. Enrollees pay average premiums of $33 a month, while people on the waiting list have the option of getting coverage by paying the full cost, an average of $332 per month.

The state is spending more than $171 million for adultBasic in the fiscal year.

Established in 2002, the program is funded with money from the cash surpluses of Pennsylvania's four nonprofit Blue Cross and Blue Shield insurers and from the state's share of a national settlement with major tobacco companies.

Gov. Ed Rendell pushed unsuccessfully for an expansion of coverage for uninsured adults during the 2007-08 legislative session as part of a broader initiative to improve health care quality, access and affordability in Pennsylvania.

He quickly ran into trouble when state lawmakers balked at a business payroll tax, a new tax on smokeless tobacco, and a cigarette tax increase the governor proposed to help finance the plan.

Even though Rendell subsequently scaled back the proposal, the session ended in a stalemate between the Democratic governor and Senate Republicans over the size of the expansion and how to pay for it. Senate Republicans wanted to use existing state revenue only, while the administration proposed combining state money with funds that would become available under a Medicaid waiver requiring federal approval.

Rendell has vowed to revive his effort next year and continue his push until he finishes his term in 2011.

Senate Republicans plan to reintroduce a health plan they advocated earlier this year, which would expand adultBasic by using revenue from the current 25 cents-a-pack cigarette tax and surcharges paid by motorists cited for moving violations, said Erik Arneson, spokesman for Senate Majority Leader Dominic Pileggi, R-Delaware.