How legislature dealt with health care needs

(Content for the following report was provided by citizen lobbyists affiliated with the Healthy Washington Coalition.)

Washington’s legislature fell well short of dealing effectively with critical health care needs during the 2011 regular and special sessions.

Because legislators failed to offset a multi-billion dollar revenue shortfall by closing any of a multitude of existing tax loopholes, deep cuts in essential services were inevitable to balance the biennial budget.

Legislators wrestled with agonizing decisions about funding for human services in the third year of a grinding recession marked by long-term double-digit unemployment.

Among the programs that felt the budget ax to one degree or another were the Basic Health Plan, Apple Health for Kids, Maternity Support Services for low-income women, Family Planning services, Public Health departments, and Primary Care and Clinic services.

The legislature also confronted the challenge of maintaining a viable healthcare safety net while preparing for the establishment of a state health care exchange in 2014, as mandated by the federal Affordable Care Act.

The health care exchange bill signed by Governor Christine Gregoire provides for the mandated exchange, but advocates were disappointed by its failure either to provide a public option, or to require the exchange to function as an active purchaser of care.

Passage of the bill was essential to maintain the state’s eligibility for federal funding to implement the new exchange.

Here’s the good news/bad news breakdown of legislative action on specific health care programs:

Basic Health Plan: The governor had proposed its elimination. The legislature tempered that drastic proposal, but froze out new enrollees for two years, shrinking BHP coverage to 34,000 by 2013. Some 150,000 uninsured men, women and children are already stuck on the waiting list.

Apple Health for Kids: The governor’s proposal to end coverage of 27,000 undocumented children was shelved, as was a state senate proposal to end the state’s commitment to cover all eligible children. The budget as adopted raises premiums for undocumented children in families whose income is above 200 percent of the poverty level.

Regulating Insurance Companies: A bill requested by the insurance commissioner and signed into law requires that the reasons for any insurance rate increase request be available for public inspection.

Guaranteed Health Care for Children: The federal law requires that children be covered regardless of any pre-existing condition. The legislature enacted a bill requiring private insurers to make any individual insurance plans available to all children under age 19.

Maternity Support Services: Low-income women with high-risk pregnancies will be served by a program whose budget has been cut by 30 percent.

Family Planning: On the plus side, women will have more access to Medicaid family planning services as a result of legislative action. However, funding for Department of Health family planning for low-income women is cut by $2.25 million, a cut that’s likely to generate $9 million in new costs for unintended pregnancies. Funding was maintained for cancer screenings, for HIV/AIDS services, and for screening for most sexually transmitted infection.

Public Health Departments: After the governor’s across-the-board cuts last December, the legislature imposed an additional $10 million cut in flexible funds for these agencies. This will lessen the ability of health departments to implement programs for food safety, safe drinking water, and the control of communicable disease.

Primary Health Care and Clinics: The legislature moderated the cuts originally proposed for community health centers, and it fully funded Disability Lifeline medical services. However, the funding cuts in other health care programs will add thousands to the state’s uninsured ranks. The safety net will be severely strained.