First you lose your job, then you lose your health insurance. If you take a lower-wage job, chances are you won’t get health coverage with it. As a result, there are now more than 1 million people in Washington without health insurance.
Debate all you want about the long-term policy answers. In the meantime, the morally and fiscally responsible choice for our state is clear: Save lives and money by keeping people insured.
With health insurance, people get preventive care and can treat conditions like diabetes, heart disease and cancer before they spiral out of control. Without it, people suffer unnecessarily and we all pay higher premiums and more in taxes because we force people without insurance into expensive emergency room visits at the last minute.
Washington’s Basic Health Plan (BHP) used to address this problem by sharing the cost of health coverage with participants on a sliding scale based on age, family size and income. If your job didn’t pay much and didn’t offer health coverage (the two often go hand-in-hand), you could enroll in Basic Health. You paid your share and got insurance, much like any employer-provided coverage. The state made up the difference between the premiums paid by participants and the actual cost.
For example, let’s say you were married, age 45, and had a couple of kids. You need health coverage for you and your spouse, and together the two of you make $2,500 a month ($30,000 a year). You would pay $180 a month ($2,160 a year) for BHP coverage. On the other hand, once you and your spouse turn 55 your premium is $3,693 — that’s about one-eighth of your total yearly pretax income.
How many people get Basic Health? The high point was in 2003, with enrollment at 130,000. That was thanks to a vote of the people that increased cigarette taxes to extend Basic Health coverage. That initiative — Initiative 773 — was approved with a two-thirds majority across the state.
But then, during the 2003-2004 recession, the Legislature kept the money from the cigarette tax, but “reprogrammed” it for other purposes. So Basic Health was cut off for 30,000 participants. Sort of a heartless thing to do in that recession, when more people were losing their private health coverage. But that has been the pattern for the Legislature.
Whenever we have a funding shortage, one of the first things to go is Basic Health. In 2010 the Legislature shrank coverage to 64,000. This year the governor and the Legislature cut Basic Health even further — only 40,000 people get coverage. Today if you try to enroll in the BHP, you’ll be on a waiting list behind 141,000 other Washingtonians. Even if you have BHP coverage now, you may not for much longer. Gov. Christine Gregoire’s proposed budget for 2011-13 would end the BHP completely.
In making decisions to cut public services, the Legislature hides behind Initiative 1053. That’s the initiative that says, “raising taxes must be approved by two-thirds legislative majorities … ” That hasn’t deterred Reps. Marko Liias, D-Edmonds, John McCoy, D-Tulalip, Mike Sells, D-Everett and Mary Helen Roberts, D-Lynnwood. They are proposing a bill to close tax loopholes enjoyed by Bank of America and Chase Morgan, private jets, elective cosmetic surgery and out-of-state coal. House Bill 1847 would raise about $75 million a year to fund Basic Health. That money, combined with a federal match, would provide coverage for 60,000 people. That still doesn’t take care of all the people on the waiting list, but it is a whole lot better than nothing.
But what about Initiative 1053? The Legislature just needs to read our state’s Constitution. Article 2, Section 22 states, “No bill shall become a law unless … a majority of the members elected to each house be recorded … as voting in its favor.” That’s the Constitution. It doesn’t say two-thirds. It does say that we make laws with a simple majority of legislators. Sounds like democracy, doesn’t it?
The Legislature should pass HB 1847. Sure, the corporations would sue. And then the state Supreme Court would have to rule on the constitutionality of I-1053, which enables 17 senators out of 147 legislators to block any legislation to raise revenue to fund essential services. The constitution is on our side. Let’s use it to fund Basic Health.
John Burbank is executive director of the Economic Opportunity Institute (www.eoionline.org). His e-mail address is email@example.com.