Will Basic Health Become Unaffordable?

The budget signed by the Governor last month included a 43 percent cut in Basic Health, a program that provides health insurance to lower income Washingtonians. The Health Care Authority (HCA) was given the unenviable task of figuring out how to make the cuts happen.

The HCA considered a number of approaches that would have directly and dramatically reduced the number of people enrolled in the plan. Finally, they settled on sharp increases in premiums and deductibles.*

This option may have some advantages over the alternatives, but it does not mean that people won't end up uninsured. The cost increases are likely to make enrollment unaffordable for many.

The table below compares the current and proposed premiums for a single enrollee aged 40-55 (premiums are on a sliding scale based on income and age). The highest increases are for those earning between $20,036 and $21,660. Their premium would raise by $780, requiring them to spend 11 percent of their annual income on premiums.* Premiums for individuals under $13,538 would double. In addition to the increases shown in the table, the annual deductible will rise by $100.

If Basic Health is made unaffordable, it will no longer serve its purpose as a source of health insurance for people who lack other options, including the 30,000 people currently on the waiting list. That purpose cannot be maintained under a 43 percent budget cut; it will require bold action by state policymakers.

*The Health Care Authority has also identified 5,000 people on the progam who also receive benefits through Medicaid and another 3,000 who the agency believes may qualify for the federal program. They will be transitioned off Basic Health and onto Medicaid.