The state’s Health Care Authority will save $238 million by raising health insurance premiums and out-of-pocket costs for the Basic Health Plan on Jan. 1. But it won’t toss any low-income workers completely off coverage, as once feared.
The average enrollee will see monthly premiums rise to $61.60 per month, up from $36, and the lowest premiums double from $17 to $34 per month in January. Participants also will see out-of-pocket deductibles jump from $150 to $250.
“We are fully aware that this decision will impact many people in the program. Even a $17 a month increase can be tough for a family struggling to get by. But this option gives those families a choice. No one qualified for the program will be arbitrarily removed,” Health Care Authority administrator Steve Hill said in a statement Monday.
“I think that when you are looking at somebody living at poverty, at less than $1,000 per month, and their premium goes from $36 to $60 a month … that is really significant,” said Rebecca Kavoussi, spokeswoman for the Community Health Network of Washington. “These are folks for whom that additional $30 or $40 could be spent on something they really need like rent or groceries. So I think a lot of them may unfortunately make the decision to drop their coverage.’’
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Even so, Kavoussi called the plan “the lesser among many evils” that the Health Care Authority had to choose from under the Legislature’s budget orders, which lopped funds by 43 percent. The network represents 140 community clinics that served 600,000 people last year, and Kavoussi said those patients included a quarter of the state’s uninsured and more than 60 per cent of the state’s BHP enrollees.
Republican Rep. Doug Ericksen of Ferndale questioned the Health Care Authority’s math, which assumes a reduction in total enrollment to 75,000 by year’s end. Ericksen contended that the GOP had a better plan rejected by Democrats in the spring that would have given people ages 19-34 an alternative to the BHP rate hikes.
Hill announced the program changes at a Seattle news conference, averting what could have been a lottery or an arbitrary last-in-first-off rule to push people off coverage. The BHP gets a monthly state subsidy of about $205 per enrollee and covers more than 100,000 people; lawmakers had predicted as many as 45,000 would be forced off the rolls.
Hill’s announcement came as state Insurance Commissioner Mike Kreidler, a Democrat, announced an expected surge in the state’s uninsured to at least 876,000 by year’s end, up from 726,000. Kreidler blamed it on job losses resulting in losses of insurance and the BHP cuts.
Health Care Authority spokesman Dave Wasser acknowledged the agency’s plan moves a number of people off the plan. It assumes about 2,000 per month will drop coverage.
It also potentially shifts 5,000 people who double-enrolled on BHP and Medicaid to just the Medicaid program. A letter went out Monday notifying those people that they will be moved Aug. 1, unless there is an “extenuating circumstance,” Wasser said.
The agency also is looking to move BHP clients eligible for Medicaid to the state-federal program. Wasser said more frequent income checks also are planned to identify people who should not be on BHP.
All told, Wasser said he thinks the program might be sustainable for about 60,000 to 70,000 people at the new premium and rate structure. Families with incomes up to 200 percent of the federal poverty line, or about $42,000 for a family of four, can qualify.
Gov. Chris Gregoire supports the plan, according to the agency. It grew out of “a set of guiding principles” worked out with the governor to protect the most vulnerable and keep the program viable.
Seattle-area software developer Justin Wilcox said he is hanging onto his coverage, despite the rate hike, because Basic Health remains his best option. He said BHP helps him keep costs down at his two-employee medical-software company as it gets off the ground.
“To date we are not profitable; we foresee that in the next 18 months or so. Right now Basic Health is really the option for my health insurance. I looked at other health insurance options; they are prohibitively expensive today,’’ Wilcox said. He has paid less than $50 per month for BHP and private-market options were $300 to $400 a month, he said.
Under the authority’s plan, the highest rate will go from $135 per month to $201.
On the net
• For details on the Basic Health Plan proposals, go to: www.basichealth.hca.wa.gov/documents/handouts.pdf.
• State Insurance Commissioner Mike Kreidler created a Web site offering “first aid” help for consumers looking for insurance at: www.insurance.wa.gov/consumers/FirstAid_Uninsured/index.shtml.