Policy Brief: Doing better than “getting by”: How to expand WA Basic Health

The number of people without health insurance in Washington has climbed over the last decade, even during economic upswings. At the same time, enrollment in Washington’s Basic Health Plan has fallen dramatically, the result of several years of compounding state budget cuts. Today, Basic Health covers only 35,000 residents, and more than 157,000 are on the wait list due to shortfalls in state funding.

In 2014, the Affordable Care Act (ACA) will ensure health care for all those covered by Basic Health. In the meantime, lawmakers may choose to maintain Basic Health through 2013. However, mere maintenance will not address the failure of the private insurance market to provide coverage to growing numbers of Washington residents.

There is a better alternative – one that expands Basic Health coverage without raising new revenue: The legislature can authorize the state to issue revenue bonds for a portion of the Tobacco Settlement revenues. Doing so will enable Basic Health to cover more than 155,000 people –  including the majority on the current wait list – as Washington voters originally intended.

Factors that favor revenue bonding:

• Bonding existing revenue requires only simple majorities of the legislature to pass.

• A lump-sum payment is worth more today than an equivalent stream of revenue apportioned to future years. The future value of $1 million is not as much as its present value. This devaluation is compounded by inflation. For example, the purchasing power of $1 million 20 years ago would require nearly $2.5 million today to have the same value.

• Bonds issued by the Tobacco Settlement Authority are the obligation of the Authority, not the state.

Get the full story in EOI’s latest policy brief: Doing better than “getting by”: How to expand WA Basic Health