State reopens health plan

JOSEPH TURNER; The News Tribune


Olympia, WA - The state again is letting more people sign up for subsidized medical coverage under the state's Basic Health Plan after freezing enrollment for a year.

But it's not the program it used to be, and those who sign up now will be paying more for their health insurance, office visits and other services.

Enrollment in the plan has dropped to 101,000 from a high of 136,500 people in November 2002.

"We are now down to the level we were shooting for and making offers to people who were on the waiting list to enroll in the program," said Dave Wasser, spokesman for the state Health Care Authority, which oversees the Basic Health Plan.

"We're going to hold (enrollment) at the 100,000 level now."

The Legislature, in an effort to balance the state budget, told the Health Care Authority to cap enrollment at 100,000 at least through mid-2005. It also told the agency to raise monthly premiums and patient co-payments so it could live within its lower budget.

Those higher charges won't take effect until Jan. 1 and even though they appear modest, they might further discourage enrollment, Wasser said. In some instances, the cost of medical coverage and treatment could be $300 to $600 higher for a family next year.

"We've never had this big of a change in benefits before, so we don't know," he said.

People can enroll in the Basic Health Plan if their annual income is less than 200 percent of the federal poverty level, or about $36,000 for a family of four.

One reason for the steady decline in enrollment is more aggressive enforcement of eligibility requirements.

Generally, some 3,000 to 5,000 people leave the plan each month because they find a job, enroll in a different medical program or move out of state. But auditors also are more often verifying income to see whether they are truly eligible for the state subsidy.

Wasser said from July 2002 through June 2003, auditors found 2,500 households who earned too much money to meet eligibility requirements. Those people were booted off the rolls and the state has billed them $3.2 million for overpayments. So far, the state has collected $1.9 million.

"We have been more strident in cracking down," Wasser said.

He said about 30,000 people have inquired about getting into the BHP since the freeze took effect. Those people will be contacted on a first-come, first-served basis to see whether they are still interested in coverage.

The Basic Health Plan was supposed to be expanding, rather than shrinking. Voters in November 2001 passed Initiative 773 and raised cigarette taxes by 60 cents a pack and boosted other tobacco taxes. Most of the $160 million a year from the higher taxes was supposed to provide state-subsidized health care to the state's working poor.

In fact, there should have been as many as 175,000 people in the Basic Health Plan by mid-2005. But faced with a $2.7 billion shortfall in the state's $54 billion two-year budget, lawmakers capped enrollment at 100,000.

That cap is likely to stay in place for another 18 months. Gov. Gary Locke did not increase funding for the plan in the revised 2003-05 budget he released two weeks ago.

Joseph Turner: 253-597-8436

How to apply

To apply for enrollment in the state Basic Health Plan, call 1-800-660-9840 or go online at


Even if you can enroll in the state-subsidized Basic Health Plan next year, it will cost you more out of pocket for medical coverage. The comparisons below are for a single person in Pierce County, age 19-39, who works full time at a minimum-wage job and has no children.

Year 2003 2004

Annual deductible None $150

Office visit co-pay $10 $15

Tier 1 prescription co-pay $3 $10

Tier 2 drug co-pay $7 50 percent

Monthly insurance premium co-pay $47.04 $51.20

SOURCE: State Health Care Authority

Joseph Turner, The News Tribune


In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only. [Ref.]

Back to Current Edition Citizen Review Archive LINKS Search This Site