Matrix offers real health care options

Thousands of Washington residents have no health insurance, but may be eligible for several programs that make low-cost coverage available to many households with surprisingly high incomes.

Many just do not know they qualify.

One answer may be the Health Care Options Matrix, a brochure created by Foundation for Health Coverage Information and recently released through the Spokane chapter of the National Association of Health Underwriters(NAHU) . The matrix is a spreadsheet that concisely lays out information about health insurance options for women with breast or cervical cancer, senior citizens, children and other groups. Coverage, eligibility and costs are summarized. Telephone and Internet contact information is provided.

For example, the matrix identifies Healthy Kids Now as an option for children in families with incomes up to 250 percent of the federal poverty level, which in Washington is $4,167 for a family of four. The premium is $15 per month. About 1,000 children in Spokane County are enrolled.Still, statewide, an estimated 115,000 children remain uninsured. Nationally, that figure is 14 million.

Lesley Hutson, president of the Spokane Chapter of NAHU, says uninsured individuals and families are often not aware of public insurance programs are available, do not know where to get information, or are unwilling for whatever reason to apply.

“We believe more people have resources if they would just take advantage of them,” says Hutson, who is also an account executive with Fidelity Associates, a Spokane insurance brokerage.

She says distribution of the matrix is an industry effort to get more information to the public in a format that’s accessible. But the press run for Washington was only 5,000, so she is trying to figure out where they can be distributed to best effect.

“We’re in the process of getting it out to the people who can get it out to the people,” Hutson says. The brochures, she notes, could be distributed by employers who cannot afford insurance but want to connect employees with what assistance they can.

The matrix is patterned after one developed in 2002 by Philip Lebherz, executive director of the Foundation for Health Coverage Information.

Foundation spokeswoman Marilyn Haese says Lebherz realized that many of California’s 6.7 million uninsured residents were eligible for some degree of health coverage. The matrix was his response to the problem.

Besides the brochures, the foundation has established a toll-free telephone number. Operators determine whether callers are eligible and, if so, refer them to the appropriate social service agency in their county. Translators are available for if a caller is not English-speaking.

Haese says the center has fielded almost 10,000 calls since it was opened last year. She expects the traffic to increase substantially as each state launches its own matrix. Information about the Washington version is already available to operators, she says.

Haese says the State of California is moving aggressively to get more people insured because the availability of federal funds to match state dollars spent on health care could bring down the overall cost of treating the health problems of the state’s low-income population. The matrix helps by publicizing new programs authorized by the governor and legislators.

“Once they sign the bill there’s not a whole lot of effort to get the information out,” Haese says. “That’s the mission of the foundation.”

Hutson says Washington residents can find out more about their choices by logging on to the foundation Web site, www.coverageforall.org., where a pdf version of the matrix can be found by clicking on “free pamphlets.” A matrix for Idaho residents is also available. There is also a link at the Web site of the Spokane Association of Health Underwriters, www.spokaneahu.org.

The toll-free number to connect with the call center is 1-800-234-1317.

There is more local help available at Community-Minded Enterprises, which runs Health for All. That program also helps families find coverage. The hotline there is 444-3066 for Spokane County residents, 1-860-444-3066 for residents of nine other Eastern Washington counties.

The health insurance system in the United States is beyond understanding, but the matrix may help.