Basic Health Plan is near capacity

Officials unsure why program is full

By Adam Wilson | The Olympian • Published August 13, 2008

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Enrollment in the state's health care plan for the working class rose 2,000 people this year, but it's not clear whether the increase is because of a weakening economy.

The state Basic Health Plan is designed for people who earn too much to qualify for Medicaid, but don't have access to health insurance at work. The state can sign up to 105,500 people on the plan and had just 242 openings left in June.

Officials aren't sure why the program is near capacity. More people might see it as a cost savings, word about it might be spreading or memories of earlier cuts to the program — it had room for 133,000 people in 2001 — could be fading.

"It could be that people are just getting over that issue: 'OK, yes, I did try before, and I didn't get on, and now I'm going to try again,' " said Molly Belozer of the Community Health Network of Washington.

The clinics in the network serve 600,000 low-income patients a year, but only get about 7 percent of their income from the Basic Health Plan or other public insurance plans.

Increases planned

The Legislature provided money to increase the Basic Health enrollment cap by 1,000 in July, and to 107,000 from next January to June. Then a new budget cycle begins, and legislators face a projected budget shortfall of $2.7 billion.

Community clinics are worried the program will be cut again, just when it is back in demand.

"We would love to see more because there's clearly so many people who could still benefit from it. If you look at the total uninsured adults in our state, there's like 350,000 that are actually eligible," Belozer said.

Past cuts have hurt the Basic Health Plan's popularity, acknowledged Dave Wasser, a spokesman for the agency that runs it, the Health Care Authority.

"For some reason, that kind of bad news hangs in the air like bad cigar smoke," he said. "When there is news in the air that there are no longer waiting lists, that doesn't get out."

But the plan has no marketing budget, so if word is spreading about open slots, it's through the efforts of groups such as the Community Health Network, Wasser added.

Enrollment levels change, he noted. About 3,000 leave the plan each month, so it can go above capacity temporarily, as it did last summer before enrollment dropped through the end of 2007.

"Sometimes, if we see a change in the premiums they pay at the beginning of the year, (enrollment) will go down. Christmas time — people are trying to find a way to pay for Christmas presents and enrollment will go down," Wasser said.

There have been no official proposals to reduce the capacity of the plan, but it typically has been trimmed during lean budget times, he added.

The average cost to taxpayers for an adult on the plan is $217 a month. That can vary widely because people pay more the more money they make. The maximum monthly premium is $277, and the lowest is $17.

The most a person can make and still qualify is $22,800 a year.