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Basic Health Plan: A pattern for the nation

Post by Patrick O'Callahan on April 3, 2010 at 6:02 pm with 2 Comments »
April 2, 2010 6:05 pm

This editorial will appear in tomorrow’s print edition.

It helps to have friends in high places.

When President Obama signed the new health care reform package March 23, he was also – thanks to U.S. Sen. Maria Cantwell – throwing a lifeline to Washington’s 23-year-old effort to give medical insurance to the working poor.

That brave and pioneering effort is known as the Basic Health Plan. Originally conceived by U.S. Rep. Jim McDermott when he was a member of the state Senate, it ultimately attracted broad Republican support. When the Legislature transformed it from a pilot project to a permanent program in 1993, the vote was unanimous in both House and Senate.

Considering that the BHP was a pricey social welfare program that captured no matching federal dollars, that unanimity was as close to a miracle as you find in state politics.

The reason for the bipartisan support is worth revisiting in the bitter national argument over the new federal law. GOP lawmakers originally bought into the Basic Health Plan because it reflected fundamental, traditional principles of personal responsibility.

The program’s low, subsidized premiums were designed for Washingtonians who held down jobs but didn’t make enough money to buy health policies at market rates. The working poor, in other words – people whose wages left them ineligible to qualify for the Medicaid coupons that came with welfare.
Part of the idea was to help the poor stay afloat while working. Welfare-dependent families could go to the doctor; why not families who were trying hard to stay off welfare?

That’s also part of the logic behind the national expansion of health coverage under federal health reform. Roughly three-quarters of uninsured Americans could be defined as working poor, earning up to 200 percent of the federal poverty level – for example, into a family of fourgetting by on $44,112 a year or less.

On such incomes parents must choose between paying the rent and buying groceries or paying health premiums. Insurance nearly always takes a back seat to shelter and food.

America provides coverage for the non-working poor, and even the most conservative Republicans seem OK with that. The argument for offering affordable insurance to those who work seems at least as strong.
Washington’s Basic Health Plan eventually fell on hard times because its costs rose faster than expected and the Legislature found it increasingly hard to cover those costs. Last year, amid a brutal fiscal crisis, lawmakers took a meat ax to the program, cutting it by 40 percent and forcing tens of thousands off its rolls.

A provision Cantwell shoehorned into the congressional legislation will allow Washington to secure federal money to keep the BHP going until the reforms take effect in 2014.

On a more cautionary note, the history of the Basic Health Plan also shows what can go wrong with publicly subsidized insurance. Over the years, its administrators got sloppy and overly generous – not rigorously checking whether enrollees met the income guidelines, for example.

A lax attitude toward costs helped pull the BHP into fiscal and political crisis. Precisely the same has been happening to Medicare. The federal expansion of health insurance will meet the same fate if no one is minding the bottom line.

Leave a comment Comments → 2
  1. nonstopjoe says:

    The Oregon Health Plan has been having problems as well – it’s always a lack of money.

  2. The Honorable Senator Cantwell recently sent me a Newsletter in which she said that after nearly a century, Obama signed Health Care Reform into law. In reality, what happened was in about a year and a half, Reid, Pelosi and BO rammed an atrocity through the political process against the will of over 75% of the citizenship using every underhanded, back room deal and political shenanigan one can imagine.

    The Senator said that Health Care costs would have bankrupted our economy within 10 years but again the fact is that out of control government spending has already brought our nation to the brink of financial collapse. The issue regarding this smoldering subject is not really Health Care but “Control”. Both of our Washington State Senators and my Congressmen all played partisan politics to take a sixth of our economy away from the free market and put it under the control of the government.

    The Newsletter said that this new mandate will reduce our Federal deficit by 1.2 Trillion Dollars within 20 years. Given the financial track record of our government recently, how many believe that? They tell us Health Care is a right not a privilege but they forget that it is God that gives rights not the government and let the reader be reminded to beware when someone tells you that something is free.

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