State reopens health plan
JOSEPH
TURNER; The News Tribune
12/27/03
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
joe.turner@mail.tribnet.com
How to apply
To apply for enrollment in the state Basic Health Plan, call 1-800-660-9840
or go online at www.basichealth.hca.wa.gov.
RISING COSTS FOR MEDICAL COVERAGE
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