State's Basic Health Plan Ramping Up

Ruby de Luna
07/13/2009

Washington residents who can't afford health insurance on their own now get coverage through the state's Basic Health Plan. About 100,000 people are enrolled in the public–subsidized program. But that number could soon change. Last month the state decided to raise rates to offset costs; a move that's expected to cause as many as 17,000 people to drop out of the program. Later this summer, members will find out just how much more they'll have to pay to stay on Basic Health. KUOW's Ruby de Luna spoke to one Seattle–area woman to find out how the rate hike could affect her.

Brace: "I'm using the hand bike which helps to build my strength with my arms so that when I go back to work that I can be strong enough to do the things I need to do."

When Sherie Brace is in physical therapy, it's not just her arms and knees at work. She uses the quiet time to think about things that need to get done. Lately, there's been a lot on her mind, and medical insurance tops that list.

Brace: "I'm thinking about, if I don't go back to work soon, how am I going to be able to afford my medical for Basic Health. They say they're going to double up the premiums. I'm concerned and looking hard for work so I can have money to pay for it, because if I don't I'd have a very sad, hard life."

Brace considers herself lucky, and is thankful to have medical coverage through basic health plan. She's been on the state's insurance program for over a year. It costs her $22.50 a month, plus a $15 co–pay for each doctor's visit, and $10 for every prescription.

Twenty–two fifty a month may not seem like a lot for health insurance. But when you don't have a steady source of income like Brace, it's a big hardship especially if you're the sole breadwinner in the family. Brace works as an in–home caregiver for elderly people. She hasn't been able to work for the past few months; she's recovering from a knee surgery. Her doctor has given her clearance to return to work. Today was her first day back on the job. She worked four hours this morning. She doesn't know when her next job is going to be.

Brace: "I don't know what I will do but I hope and pray that it works out and I hope they come across some work and like I say I've been out looking for jobs myself through different companies in hopes to find something else."

Reporter: "What's the market been like?"

Brace: "It's not been great."

Brace won't know until late summer how much more she'll have to pay to keep her coverage, or how much her new deductible will cost. Right now the state is taking bids from different health plans. By mid–August officials will evaluate the proposals, and choose a menu of plans. By October, during open enrolment season, members will have to decide whether to renew, change or drop their health coverage. Dave Wasser is spokesperson for the State Health Care Authority, the agency that administers basic health. He says they're not sure yet how many people will drop out of the program as a result of the new rates.

Wasser: "There will be some people who'll say this is too expensive, and they will leave. But it will generate more revenue for us so that we can actually increase the number of people that we wouldn't have been able to cover had we just gone along with the budget cut that the Legislature put before us."

In the last legislative session, lawmakers cut the program's budget by 43 percent. In addition to the new rates, the agency identified 5,300 people who receive both Medicaid and Basic Health. Next month, the state will move these members with double coverage out of basic health and on to Medicaid entirely. Wasser estimates another 3,000 will qualify under that program. By 2010 the Health Care Authority hopes to bring membership to a sustainable level of 75,000 for now. If the state's economic situation doesn't improve lawmakers could consider more cuts to the program.

Wasser: "What makes Basic Health an attractive place to cut is that it is a state–funded only program, there are no federal funds that are being comingled into the program so that makes it, for lack of a better term, an attractive place to cut when the situation gets bad."

The changes to Basic Health comes at a time when more people are losing their medical insurance because they've lost their jobs. And even if they are employed, they simply can't afford it on their own. The program was created in the early 1990s to make health care affordable to people who are low–income or working poor like Sherie Brace. Brace says having medical insurance means she's able to have a life.

Brace: "A life that I can actually get up, I can go do what I need to do, I can go out and look for a job. If I didn't have the health care and I didn't have the medication, I couldn't get out of a wheelchair to do so."

Brace and her teenage daughter survive on food stamps. Money has been so tight that she started to cut back on things like medicine. She stopped taking her asthma medication because she can't afford it.

Brace: "I know it scares the heck out of my doctor. If I start to get a cold, my asthma kicks in really bad and then I start to get scared."

There's one glimmer of hope for Brace. She recently found out that her employer offers a $50 monthly allowance for health–related things, including medical insurance. Brace hopes to use the money to pay for her health premium. But in order to tap into that benefit, she needs work soon.

I'm Ruby de Luna, KUOW News.

© Copyright 2009, KUOW