Doctors, administrators, patients and other Washington state residents responded to a Huffington Post request Thursday for first-hand stories about the state's Basic Health program.
The state's plan entered the national health care debate on Thursday when an amendment modeled on it was adopted by the Senate Finance Committee.
The measure, championed by Washington Democrat Sen. Maria Cantwell, is as close as the conservative committee got to a public health insurance option for consumers who want an alternative to private insurance coverage.
HuffPost's unscientific survey indicates that residents who are or who have been covered by the plan are satisfied with it. But many can't get in; one referred to it as the "holy grail." The plan is massively underfunded and a frequent target of budget cuts. Washingtonians who meet the eligibility requirements face a waiting list that is 38,000 people long and getting longer.
An employee of one of the organizations that administers Basic Health wrote in, requesting anonymity because he couldn't speak for the program. The budget cuts have it under intense pressure. "They've talked about several different ideas as to how they'll choose which people are going to lose their coverage, but I'm not sure whether they've chosen one," he wrote.
Cantwell spokesperson Ciaran Clayton said that taking the program national would ease the funding crisis because federal money would be combined with whatever the state kicked in.
Jeffrey Lee, a family physician, said he has extensive experience with Basic Health. "The plan is true to its name. It's very basic, and still leaves a lot of things uncovered," he said, echoing other readers. "But it's been a godsend for patients who don't qualify for Medicaid, yet have no insurance through their employer."
Lee practices at a community clinic in Seattle, which he said has resorted to paying some poor patients' premiums for them, to keep them on the program. Someone who loses Basic Health now is unlikely to get it back any time in the near future.
DJ Wilson, who runs Wilson Strategic Communications, wrote that he represents 600 physicians, several health plans and Children's Hospital in Washington. He previously worked for the Health Care Authority, the state agency that runs Basic Health. "I think the BHP works really quite well," he wrote. "The challenge is - as always - funding. This last year, we moved to cut a number of slots, but ended up raising premiums instead - a good trade off in the end.... The basic model of the BHP is that the state fixes a benefit package, and then based upon funding, determines how many 'slots' of eligibility there are that can receive the benefit plan. It has a narrow eligibility pool -- like the Cantwell amendment -- but it works very well for many of our families which would otherwise be among the 'working uninsured.'"
A number of readers wrote in to say that they are among those 'working uninsured' who make too much money to qualify but not enough to afford private insurance.
Many of those that are in count it as a blessing. "My family has been subscribing to the Basic Health plan here in Washington state for 5 or 6 years now, and it works just fine," wrote someone who identified himself only as Peter. "We currently pay $45 per month, but that's going down to $34 after my most recent re-certification. As a full-time college student, my income drops during the school year when I go to part-time status at my job, and the re-cert takes this into account. We have a $15 co-pay for office visits, a $100 co-pay for ER visits, prescription coverage, and a cap on out-of-pocket expenses per year. No dental; no vision; but all in all it's not bad."
Many who liked the plan cautioned that it shouldn't be seen as an alternative to a robust, national public option. "I LOVE basic health, (it has helped me a lot, and helped my mom tremendously), [but] I feel that basic health is NOT a replacement for the public option," wrote Frank.
After being on the waitlist for roughly a year, Andrea and her husband made it onto Basic just in time, they wrote. "A few months after we got our coverage, I learned I had to have a hysterectomy. Basic Health inquired as to whether the condition, fibroid tumors, was pre-existing. While it probably was, because those things don't show up overnight, I hadn't known about it, and they didn't argue. My share of the over $20,000 bill was about $1,200 or so, as I recall," she wrote. "It seemed reasonable at the time and we were very thankful we had managed to get insured."
If she were applying today, however, she'd still be waiting.