Washington's "Public Option" Health Insurance Plan, Coming Soon?

PSBJ's Peter Neurath has been doggedly trying to piece together the facts about what he calls Washington state's "public option"--barebones insurance coverage with a low premium that would cover up to $75,000 in costs per year. Neurath is floating $100 per month as an example of "low."

Washington state has a Basic Health plan for low-income residents, but its popularity with enrollees is not matched by an equal legislatorial enthusiasm for funding it. 75,000 people are enrolled currently, with 90,000 on a wait list, but Gov. Gregoire's first, "all-cuts" budget actually defunded the plan, and part of her solution has been to demand federal aid.

Earlier this year, word came out that the Health Care Authority was mulling a low-cost alternative to Basic Health, and Neurath started following the story. Now the HCA is shopping the idea with private insurers, several of whom expressed interest in the "talking about talking" phase. We'll know if there's serious interest by March 5, and if private insurers are willing, the plan could be offered by July 1 of this year--just in time for Basic Health's rolls to be decimated, if funding can't be found.

The HCA's Peter Wasser says Washington had a a non-subsidized plan up until 2002, which in its good intentions, shot itself in the foot. A short pre-existing condition window meant people gamed the plan, joining it only while they were sick.

The new $75,000 plan would be structured like Basic Health: no dental or vision, with co-pays. There would be a $250 annual deductible and a $1,500 out-of-pocket maximum per person. A high-risk questionnaire would separate out people who would clearly require more care than the plan could provide.

So far the idea has managed to unite both Republicans and Democrats in opposition to it, although their input is not needed for the plan to proceed. Looking out for our state's neediest and most vulnerable, Republican Sen. Cheryl Pflug has sponsored a measure, SB 6812, that would let private insurers offer the same $75,000 "deal" on their own.

State Democratic Sen. Karen Keiser, chair of the Health and Long-term Care Committee, argues that $75,000 isn't enough coverage, an argument perhaps less persuasive for Washington's 875,000 uninsured, who currently have nothing and are not expecting full coverage from Keiser this legislative session.