The much-maligned Affordable Care Act — colloquially known as Obamacare — is imperfect. But the basic premise, the idea of making health insurance available for all at a reasonable price, remains valid and valuable.
With that goal in mind, Washington should embrace an opportunity to revive its defunct Basic Health Plan and fill in some of the holes in coverage provided by Obamacare and an expansion of Medicaid. While the percentage of Washington residents without health insurance has dropped from about 17 percent in 2013 to less than 7.5 percent today, many of the state’s working poor still are unable to qualify for Medicaid or afford Obamacare coverage. According to the office of Sen. Maria Cantwell, D-Wash., an estimated 162,000 state residents — those making between $16,242 and $23,540 a year — are unable to secure insurance.
That is where the Basic Health Plan comes in. The idea was forged by the state Legislature and signed into law by Gov. Booth Gardner in 1987, helping to provide coverage with affordable premiums and co-pays. As many as 150,000 residents were taking part in the plan before it was slowly shuttered and finally ended in 2013 as the Affordable Care Act was implemented.
To provide options for those who fall through the cracks of Obamacare, Cantwell has been leading the charge in Congress to make the plan available at the state level. Her amendment to the Affordable Care Act allows states to use 95 percent of the federal funding they receive to negotiate directly with insurance providers and offer coverage for low-income citizens. Cantwell said the idea uses the purchasing power of the state to negotiate group insurance for thousands of residents: “You’re giving leverage for this population. We thought it was a great idea.”
In 2014, the state Legislature considered a revival of the Basic Health Plan, with the idea passing the House of Representatives but dying in the Senate. Now Cantwell and Rep. Jim McDermott are politicking for the lawmakers to embrace the plan, enlisting support from state Rep. June Robinson, D-Everett.
Thus far, New York and Minnesota have adopted versions of the Basic Health Plan. New York reportedly has signed up about 400,000 people, and those customers pay monthly premiums of $20 along with a co-pay of $15 for a visit to their primary-care doctor. Minnesota has registered about 120,000 people.
All of this comes while Obamacare remains under fire in Washington, D.C. Republicans in Congress have tirelessly attempted to scuttle the legislation, and presumptive nominee Donald Trump has criticized the mandate that individuals must have insurance or be fined for a lack of coverage. Trump has, however, supported the provision that prevents insurance companies from denying coverage to those with pre-existing health conditions. Realistically, it would appear impossible to separate those two provisions; insurance companies say the individual mandate is necessary to prevent a situation in which people purchase insurance only when they become ill.
But the big picture shows that 11.3 million people nationwide have signed up for insurance through Obamacare, according to the U.S. Department of Health and Human Services. And the humanitarian picture suggests that making health insurance affordable for the poor in a fiscally responsible way is a necessary function of a civilized society.
Washington has made great strides in this regard, but the data demonstrate that too many residents are falling through the cracks. A revival of the Basic Health Plan could help shore up that system.
