Washington State Medicaid receives federal approval
of national health care reform “bridge waiver”
OLYMPIA – Gov. Chris Gregoire said today (Tuesday, Jan. 4) Washington state has received approval of its request for a Medicaid waiver that will let the state and federal government share the cost of the Basic Health plan and the Medical Care Services program for Disability Lifeline and the Alcohol Drug Addiction Treatment Support Act.
The waiver – intended originally as a short-term bridge to national health care reform in 2014 – will provide about $7.7 million a month in new federal funds, or roughly 40 percent of the cost of the current Basic Health plan and Disability Lifeline, which have been funded primarily by state dollars.
The Legislature had already budgeted for the new federal funding beginning this month. The two health programs are both proposed for termination as cost-saving steps on March 1, 2011, but elimination of these programs would require legislative action early in the 2011 session.
“Our state’s fiscal crisis has grown since we originally asked for this waiver,” Gregoire said. “Our options are limited, and we can no longer afford to support the safety net we once did. Options will need to be looked at to see if there is a way to additionally supplement this waiver.”
Doug Porter, Health Care Authority Administrator and State Medicaid Director, said his staff is ready to help legislators with information and support in that effort. Porter said the original strategy behind the waiver was to use these two programs as a bridge to subsidized health insurance options that will be available nationwide in 2014 under the new Patient Protection and Affordable Care Act.
“The scheduled expansion of Medicaid in 2014 will make another 470,000 low-income Washington residents eligible for our programs, and the bridge waiver will help us develop the new systems we will need in place when that big expansion comes,” he said.
Currently, the Basic Health plan has about 56,000 enrollees while another 20,000 Washington residents receive medical coverage through Disability Lifeline, formerly known as General Assistance-Unemployable, or GA-U. Another 4,000 receive medical coverage through the Alcohol and Drug Addiction Treatment and Support Act, also known as ADATSA.
Basic Health targets low-income working adults in families that do not make more than 200 percent of the Federal Poverty Level, or about $29,140 for a family of two. Disability Lifeline and ADATSA are open to people with disabilities that prevent them from working even thought they do not qualify them for long-term disability status with the Social Security Administration.
Basic Health was created in the late 1980s as a low-cost benefit package that was available in high-unemployment counties. In 1993, as part of the state’s health care reform initiatives, Basic Health was made available statewide.
Basic Health enrollment rose as high as 136,500 in 2002 but has since fallen to less than half that after several years of enrollment caps and attrition forced by budget cuts. The plan, however, remains popular as the need for services has increased in the deteriorating economy. Today, there are about 136,500 Washington residents on the waiting list in case space becomes available.
The waiver will help sustain coverage for low-income adults without children – a population with limited affordable options for health insurance today.
The possibility of a waiver from the federal government resulted from passage of the Patient Protection and Affordable Care Act, which allowed for states to plan for an early Medicaid expansion for individuals who would be eligible for Medicaid in 2014 but aren’t today.