Thousands lose health coverage
About 274 legal and illegal aliens in Spokane County lost health insurance when the state ended an immigrant medical assistance program. They’re among 17,000 immigrants who lost coverage statewide since the program ended in 2002, according to a University of Washington report released Wednesday.
The families were supposed to end up covered by the state’s Basic Health plan. Slots were reserved for them. But many failed to make the transition because of cost and confusion.
“A tremendous number of very low-income people have lost health coverage as a result of this change,” said report co-author Janet Varon in a statement. “Basic Health, with its substantial premiums, co-payments and limited coverage, is not accessible for these families. Before the change, so many could barely afford basic necessities like food and rent. When they were offered Basic Health, there was no way they could take on a new monthly health care bill.”
Problems completing the application process accounted for some of the loss in coverage, the report states. Statewide, only three in 10 immigrants successfully made the jump to the Basic Health plan.
In Spokane County, most of the families have jobs and are here legally, said Ralph DeCristoforo, project coordinator of Health for All, which went door-to-door to help the families sign up for Basic Health.
“The majority of them are legal immigrants, but don’t meet the citizenship requirement for Medicaid,” DeCristoforo said. “They are Russian-speaking families who had migrated here, but not under refugee status. They are teenage children of farm workers, who realized their families couldn’t support them so they struck out on their own.”
The state program began after the 1996 federal welfare reform law limited immigrants’ eligibility to Medicaid. Washington was among 13 states that extended Medicaid-like coverage to immigrants after welfare reform.
More recently, the state Legislature decided to move the immigrant families to the Basic Health Plan after voters passed a new state tax on tobacco in 2001. The tax brought new money to the Basic Health plan.
The change was not recommended by the state Department of Social and Health Services. It warned at the time that families would be lost due to language barriers, mobility and confusion over Basic Health’s managed care system.
“We said if we get 50 to 60 percent moved over to Basic Health it will be a screaming success,” said Doug Porter, assistant secretary for DSHS’ Medical Assistance Administration.
King County experienced the most impact with an estimated 6,293 immigrants losing coverage, according to the Children’s Alliance, a nonprofit advocacy group.
In Yakima County, where agriculture attracts migrant workers from Central America, about 2,724 immigrants lost health insurance.
The report by the University of Washington Health Policy Analysis Program and Northwest Health Law Advocates was based on state data and interviews with families and healthcare providers.
The Kaiser Commission on Medicaid and the Uninsured released the report, titled “Moving Immigrants from a Medicaid Look-Alike Program to Basic Health in Washington State: Early Observations.” It can be read online at www.kff.org/Medicaid.