Tough times for health care in Washington state | Guest column

By Maria Sunseri, Federal Way resident

Spring has officially sprung, flu season perseveres, and every cough and sneeze brings instant dread of illness and the emerging swine flu. As the battle between human and virus rages on, the topic of health care is never far from mind, and questions of health care affordability become even more relevant.

Washington state residents are being hard-hit by the country’s current economic troubles, and as more and more people are being laid-off, more and more families are losing access to employer-provided health insurance. It is in times like these that state-subsidized health care plans become of life-saving importance for families struggling to get back on their feet.

Washington’s Basic Health Plan has long been a beacon of hope for low-income Washington residents who can only afford deeply discounted health insurance. Basic Health provides doctor and hospital care, including preventative care, emergency services and prescription drugs, to about 100,000 people each month. However, beginning January 2010, the state is cutting 43 percent of funding for the Basic Health Plan, which will force 40,000 people to be disenrolled from the program and prevent any new applications from being considered.

The Legislature’s choice to cut state funding will disproportionately affect Washington’s working poor, since the Basic Health Plan is designed specifically to offer health insurance to those who could not afford it otherwise. According to a briefing report by the Joint Legislative Audit and Review Committee, 54 percent of enrollees to the Basic Health Plan have incomes below the federal poverty level. No family or individual is eligible for the plan unless they make at or below 200 percent of the federal poverty level, meaning a family of four can make no more than $38,700 per year to be considered. About 55 percent of those enrolled in the Basic Health Plan were uninsured before joining, and the dominant reason for being previously uninsured was the high cost of health insurance without the plan.

Clearly, the major effect of this funding decrease will be to eliminate insurance coverage for those who cannot reasonably afford it otherwise. Wealthier Washington residents will not be affected by these cuts, either because they are employed by a company that can provide them with health insurance, or because they make enough money to afford some level of coverage themselves. Instead, the cuts will systematically disadvantage Washington’s working poor and keep them from meeting their basic health care needs.

When discussing state-subsidized health care, it can be tempting for people who are ineligible for the Basic Health program to see it as a government handout that rewards the unemployed via the taxes of employed Washington residents. People who feel this way may view the cuts to Basic Health in a positive way, thinking that those on state-subsidized insurance plans are unmotivated consumers of unearned resources. It is important to recognize, however, that over 60 percent of the Basic Health Plan’s enrollees are employed, and 48 percent of those people work full-time. Therefore, the cuts are not punishing people who are unemployed or unwilling to find work, but are in fact punishing people who simply have low-paying jobs.

Among the unemployed enrollees, popularly listed reasons for unemployment were taking care of family, going to school, temporary disability, or having been recently laid off. It can be seen, then, that unemployed enrollees are not lazy or unmotivated, but are typically facing transitional phases in life or pressing familial responsibilities that inhibit them from working. With layoffs so prevalent in the current economy, health costs during times of unemployment are a concern for an increasing number of Washington state residents.

Cutting health care coverage for people who cannot afford it otherwise will make it harder for them to receive preventative care, and therefore increase health problems for low-income residents who will no longer be able to afford doctor visits or prescriptions. In the long run, people being unable to afford health insurance will become sicker and less likely to be able to find work in jobs requiring consistent good health. These funding cuts will therefore feed a cycle of increasing unemployment in Washington state, all the while making basic health care needs harder to meet for low-income families.

When people cannot pay for health care, they are more likely to need hospital treatment that they cannot afford, and hospitals, in turn, cannot legally turn anyone away who is unable to pay. Therefore, as more people are unable to afford health care, there will be increased use of hospital resources, which will cause hospitals to suffer and be unable to provide the usual standard of care. Increased use of hospital resources can also drive up taxes and insurance prices, which will once again disproportionately affect lower-income Washington residents.

Unless the state puts more resources back into Basic Health, illness rates among low-income Washington residents will increase dramatically, resulting in disease and higher poverty statewide. Anyone who wishes to support the Basic Health Plan should call the special legislative hotline number at (800) 562-6000 and leave a message to be forwarded to local legislative representatives who make important decisions regarding Basic Health funding. The state Legislature needs to hear that the Washington public does not agree with systematically denying low-income residents access to basic rights as important as health care.

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