As part of her effort to close a $4.6 billion budget shortfall, Gov. Chris Gregoire has proposed eliminating the subsidized Basic Health Plan (BHP), which insures some 55,600 Washingtonians with low incomes. The state caps eligibility for participation at 200 percent of the federal poverty guidelines, but 57 percent of those enrolled are below the poverty line. (Seventy-five percent of those enrolled are below 139 percent of poverty: for perspective, that’s singles making less than $15,100 per year, or a family of four making less than $31,000.).

So, just to state the obvious: the majority of these people are living in poverty. They have health insurance because of the BHP. Killing the program means taking away their health care. If that doesn’t make it clear that eliminating BHP is like putting all of its enrollees into one giant game of Russian roulette, then how about this: For small business owner Justin Wilcox, it’s a matter of keeping his business open.

Wilcox left Microsoft in 2008 to give his time to a start-up software gig in medical communication. “I own a small software company. We help share medical records between doctors and patients and other providers,” he said.

He’s been on BHP for a little over a year, and has seldom taken advantage of it. “I stepped on a lid for a [soup] can and had a couple stitches. I had some knee issues too, but nothing serious.”

If Wilcox were to be put out into the private market, he said, it would cost him at least $400 per month.

And it’s not that he has health problems. It’s the fact that he has health insurance if he ever needs it. “It allows me to have that security and go when I need it.”

So I asked him what his options are if they do cut BHP. “I’ve got two options. I’ve been eying a move to Silicon Valley. One of the things that was keeping me here was health coverage.” And if he doesn’t move, Wilcox would go for some sort of catastrophic insurance—basically to prevent him from going bankrupt.

And as Josh has written, Democrats are arguing that now isn’t a good time to cut the BHP, and Sen. Maria Cantwell just got federal funding for 40 percent of the program’s cost.

Plus: According to Basic Health Coalition Chair Molly Firth, BHP has some solid bipartisan support. “Democrats like it because we’re extending health insurance to low income people, and Republicans like it because it has an individual responsibility component [because they have to contribute].”

In addition to the copay, there’s also a monthly premium that averages about $17 per month. “And some older people are paying as much as $300 or $400 per month,” said Firth.

Ingrid McDonald with the AARP of Washington pointed out that a significant portion of BHP subscribers are elderly. “One third of people on BHP are fifty or older.”

And if BHP is cut, it will hit them the hardest: “If they are uninsured, they’re going to have the hardest time finding something in the private market,” said McDonald.

(Previously on Slash and Burn: The Gregoire Budget Story: Medicaid home care hour cuts could cost Sandel DeMastus and Calvino Neidigh-Kumm their homes, skyrocketing the cost of their care, and reducing their already difficult quality of life.)
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