Op-Ed: Future uncertain for state’s Basic Health Plan
As congressional Democrats try to secure the last favorable vote for health care reform before Christmas, it appears the government-run “public option” for the uninsured is dead…for now. I am not mourning its loss, because I've watched the pitfalls of a government-run option. I believe we can do better.
Many people may not realize it, but we've had government-run health care in Washington state for more than 20 years. It's called the Basic Health Plan (BHP). For the good that it has provided for some, the BHP also has a lengthy list of problems — all of which stem from the fact that it is government-sponsored.
The first BHP coverage began in 1988 as a pilot demonstration project in King and Spokane counties, two years after the Legislature's McPhaden Commission proposed a limited plan intended to provide health care coverage to the state's estimated 12 to 14 percent low-income uninsured. It covered preventative care, hospital and physician services, emergency room, ambulance, and maternity. Although slowly expanded to several other counties, it took only three years before the BHP reached its funded capacity. That's when waiting lists began.
As BHP was eventually expanded statewide and made permanent, the ability to cover citizens has been largely dependent upon the state budget. When we've had budget surpluses, enrollment slots have been added. In times of deficit, enrollment has been reduced — this year by 43 percent.
Waiting lists to enter the program have been the norm. In fact, BHP officials reported nearly 300 people a day were added to the waiting list this year.
The budget has also dictated premiums, co-pays and covered services of those enrolled in BHP. For example, one year BHP provided coverage for durable medical equipment, such as C-PAP machines, ostomy supplies and crutches. The following year that benefit was eliminated. Waiting periods for BHP coverage of pre-existing conditions have also increased as the budget has been reduced. Enrollees have been shifted from plan to plan as contracted providers have left, providing little consistency in coverage or doctors.
As the state increased mandated covered health services for private insurance carriers, it exempted BHP from playing by the same rules, creating another form of rationing under government coverage.
Although BHP was intended to reduce the state's uninsured through an affordable government program, 11 percent of the state's population continues to remain uninsured. And unfortunately, the state has continued to implement policies that make private coverage of health care more costly and less accessible to the public.
The future for the remaining 65,000 enrollees on this government-run health care roller coaster remains uncertain. Two weeks ago, the Basic Health Plan was the first program offered up for elimination by Gov. Gregoire in her supplemental budget proposal. It now becomes the leverage she will use to promote tax increases.
Reform of the Basic Health Plan through House Bill 2169 is one of the 10 health care solutions House Republicans have suggested for the coming legislative session which begins Jan. 11. I invite you to visit our Web site — https://houserepublicans.wa.gov/news/health-care/10-solutions — to read about our solutions to make health care coverage more accessible and affordable for all.
EDITOR'S NOTE: State Rep. Dan Kristiansen, R-Snohomish, represents the 39th Legislative District, and also serves as chairman of the Washington House Republican Caucus. He can be contacted at (360) 786-7967 or e-mail him and sign up for his e-newsletter at: houserepublicans.wa.gov/Kristiansen.