Washington’s Basic Health Plan

Fact Sheet | August 21, 2001 | By Jen Brown

Executive Summary

Overview

The Basic Health Plan (BHP) provides health care coverage to families with incomes at or below 200% of the Federal Poverty Level, which is 58% of the Washington state median income. Federal Poverty Levels are based on family size; for a family four, 200% FPL is $35,300 per year while the state median income is $61,059. Typically, BHP enrollees are low-income working families whose employers do not provide health insurance. The BHP is administered by the state’s Health Care Authority and services are provided through private health plans, including Community Health Plan of Washington, Group Health Cooperative, Regence, and Premera. Benefit coverage includes hospitalization, provider visits, emergency services, and prescriptions.

Who Pays

BHP provides a no-frills package of health care benefits for eligible Washington residents. The state pays a sliding-scale subsidy of the monthly premium. Participant premiums are based on age, income, family size, and health plan. For example, in Pierce County, a middle-aged couple in a four-person family with a household income of $2627 per month ($32,524 per year, 190% of the Federal Poverty Level) would pay monthly premiums ranging from $152.84 to $236.08 depending on their choice of health care provider.Additional co-payments are required for most services received.

History

The BHP began in 1987 as a pilot project to provide health insurance to the working poor. The program was initiated with bipartisan legislative action. BHP was made a permanent statewide program in 1993 when the Washington State Legislature mandated the implementation of universal health coverage. When the universal coverage law was repealed two years later, the legislature recognized that many low-income workers did not receive health care insurance at their places of work and retained the BHP and set a statutory enrollment target of 200,000 people. However, as a result of underfunding by the legislature, the state not only failed to meet this enrollment target but also increased co-payments and premium sharing for BHP participants and, in 2001, set a new enrollment cap at 125,000.


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