Washingtons subsidized health care program for low-income workers will be back on the chopping block next year as lawmakers try to deal with a new budget shortfall of more than $1 billion.
Gov. Chris Gregoire and others have questioned whether the Basic Health Plan, which legislators scaled back this year to a cost of $337 million over two years, can be sustained without new taxes or federal help. Lawmakers already cut more than $4 billion out of this years general fund budget, including 43 percent of Basic Healths budget.
The threat of further cuts comes as U.S. Sen. Maria Cantwell, D-Wash., and others have held up the Basic Health Plan as an example of a program that should be a piece of national reform. Cantwell early this month won amendments in the Senates emerging federal health-reform bill that would use federal dollars to help Washington and other states that adopt Basic Health-type programs pay for them.
We made reductions in the BHP before and were able to save portions of the program. The budget situation continues to deteriorate. I need all the options available in order to solve this budget shortfall, Gregoires budget director, Victor Moore, said last week.
Moore said eliminating Basic Health is on the table along with other potential cuts, and Gregoire questioned recently how she could balance the budget without new taxes, federal help or cutting programs such as Basic Health.
Basic Health is available to people with incomes up to twice the federal poverty line, or $44,000 a year for a family of four. Under the 22-year-old state-funded program, the state sets standards for coverage, and private insurers bid to be included as a choice for low-income workers who buy insurance through the Health Care Authority.
The plan still serves 84,000 low- income people but is shrinking rapidly and is expected to have enrollments down to 60,000 to 65,000 next year as the effects of budget cuts take hold. Higher co-payments, deductibles and monthly premiums that will go up from about $36 on average to nearly $62 a month will take effect in the next re-enrollment period, which begins this week.
Im sure everything is on the chopping block, said House Majority Leader Lynn Kessler, D-Hoquiam, who supports the Basic Health Plan. Again, weve been watching the feds to see what they will do. Weve had our public option for a long time, and its a great option. They pay on a sliding scale, and you get coverage (from private insurers). Its parallel to what youre earning.
From my perspective, if its a state-only program, it should be significantly scrutinized for whether we can have it as a state-only program, state Rep. Gary Alexander, R-Thurston County, said. Its possible the BHP in Washington could be eligible for federal dollars. That would change the priority for that basic program in my mind.
But Alexander and House Republicans have favored getting rid of the plan in its current form, and also cutting a General Assistance Unemployed program that provides cash and health coverage for people waiting to get federal disability help.
For Seattle-based medical software developer Justin Wilcox, the Basic Health Plan was his only option. He has been watching the national debate and sounded surprised to learn Basic Health faces still more challenges.
If I cant get health care coverage, the startup Im (creating), which has the potential of creating jobs, wont get started. I would certainly encourage our lawmakers to look for increases in taxes or look elsewhere, Wilcox said.
The threat to Basic Health highlights the uncertainty around health insurance reform. While Congress debates a sweeping solution that might help Basic Health or a replacement survive, states are struggling to hang on to homegrown solutions that have been filling in the gaps, according to Gregoire health policy adviser Jonathan Seib.
But under the emerging federal legislation, most reforms would not take effect until 2013-14.
The hanging on part is going to be easier said than done, Seib said. The bottom line is, Yes, the program is at risk, and we will look at every option to continue the program and continue to provide subsidized coverage.
Seib said one hope is that Congress provides some early funding or flexibility for states.
One of the options that may be available in the federal reform would be early expansion of Medicaid without the strings that attach now, he said.
So far, Cantwell has won amendments that would expand Medicaid and help Basic Health. She would increase Medicaid eligibility to those with incomes up to 133 percent of the federal poverty level. She would use federal funding to make Basic Health available to people whose incomes are between 133 percent and 200 percent of the federal level.
Those two moves alone would help, said advocate Rebecca Kavoussi of the Community Health Network of Washington. The network represents clinics such as Sea Mar in Olympia that handle the lions share of the states Basic Health clients.
Kavoussi said Cantwells proposal to raise income eligibility for Medicaid could let about 67,000 people on Basic Health move onto Medicaid, which splits the taxpayer cost between the state and federal governments. Cantwell also wants to make other federal money available to BHP-style plans around the country, offering additional help to roughly 110,000 more people eligible for BHP in the 133 percent to 200 percent income band, Kavoussi said.
If successful, that would adress some of the growing backlog of people waiting to get into Basic Health. Dave Wasser, spokesman for the state Health Care Authority, said the waiting list has grown to 66,000 people.
Wasser said he received calls from national news reporters wanting to know about Basic Health after Cantwell made her proposal.
What Cantwell did was put a face on what a public option might be. We got a lot of attention nationally; how does this work? A lot of national media I talked to were surprised. It seemed almost too simple, Wasser said.
The Senate bill could get a committee vote as soon as Tuesday, then go to the floor for amendments and debate, Cantwell spokeswoman Ciaran Clayton said.
Reconnections rule the day for 81st Brigade
OLYMPIA The Washington National Guard honored dozens of returning soldiers Saturday at a Freedom Salute ceremony at the Red Lion Hotel Olympia.
It was part of three weekends of ceremonies throughout the state honoring 81st Brigade Combat Team soldiers. Among the dignitaries on hand were U.S. Rep. Brian Baird, Olympia Mayor Doug Mah, Tumwater Mayor Ralph Osgood and Centralia Mayor Pro Tem Bonnie Canaday.
The 81st is headquartered in Seattle but includes units from throughout Washington, as well as the California Army National Guard, according to the military. About 2,400 soldiers from Washington and about 900 from California were part of the deployment force supporting the Iraq War from August 2008 to August 2009.
It was part of a day of reacclimation training for the soldiers and their families, intended to help them reconnect with their families and homes after months spent away, Lt. Col. Jeff Sabatine said. The sessions will continue next month.
Soldiers are getting a lot of good stuff out of this, he said.
In interviews, soldiers shared stories of their routines away from home and how drastically different they are.
Master Sgt. Eric Shriner, a Kirkland native, has spent 20 years in the National Guard. He lives in Yelm and reports to Camp Murray for a full-time job. But for almost the past year, he has lived at Qayyarah Airfield West in Iraq. Better known to troops as Q-West, the base sits about a half-hour south of Mosul.
His mission was dangerous: escorting shipments including food and medicine down roads that could be littered with roadside bombs.
He recounted giant dust storms that arose unpredictably, forcing troops to stay indoors on base for up to a week at a time. When temperatures reached 130 degrees, he worked night shifts. In the rainy winter, mud was everywhere.
His day was planned by the military some workdays were four hours, some were 12. Usually, there was one day a week to rest.
Then he had to adjust to the changes at home. His 23-year-old daughter had a baby. He also left behind an 8-year-old son. His wife, Christine, made a lot of changes to the house. They talked almost daily via webcam morning in Yelm, late night in Iraq. But the pain of separation continued.
Its really hard, Christine Shriner said.
But she added: I know what his job is, you know. I believe in what he does.
Shriner now knows hell be back at home for two years. After that, he could be deployed again.
The same goes for Sgt. Terrell Fox of Seattle. He left a son, now 10, and a daughter, now 4, about a year ago for training, then deployment to Iraq. And he missed his wife, La Quisha. It was his first time out of the country. He found that the condition in Iraq was better than what he had heard.
When we deployed, the stress level was up, but going over there really wasnt that bad, Fox added.
He said making the transition from overseas deployment to life at home is more stressful than going in the other direction. Now the citizen soldier has returned to his home life, working as a security officer at the University of Washington Medical Center and continuing his work with the National Guard in Seattle.
He noticed changes. For instance, his 10-year-old son, who became the man of the house, now is more helpful with chores.
You missed a lot in that year, Fox said.
Matt Batcheldor: 360-704-6869
