State tries to simplify Medicaid

In political circles, “Medicaid expansion” has been a phrase that launches arguments. But for uninsured poor people – 22,000 in Spokane County and 328,000 throughout Washington state – expansion means health care coverage is on the way.

Washington is one of 25 states to accept the federal government’s offer to fund the expansion of Medicaid, the health care program for America’s poor.

Idaho has not expanded Medicaid. As a result, many of its poorest residents will not qualify for any kind of assistance – not Medicaid, and not a federal subsidy to buy insurance – because the subsidies are not available below 100 percent of poverty. Federal law assumed states would expand Medicaid for their poorest residents.

But in Washington, expanded Medicaid takes effect Jan. 1, under a new name: “Apple Health.”

Now that Washington’s Medicaid is becoming a comprehensive plan for adults, said Dorothy Teeter, director of the state Health Care Authority, she hopes the public will learn that “Apple Health means health care coverage: regular doctor visits and a healthier future.”

Gone, the state hopes, will be desperate trips to emergency rooms, provider of last resort for the uninsured. Gone, too, will be the long waits for eligibility determinations and the complex patchwork of state programs that cover some low-income people but not others. In the past, children or pregnant women could get Medicaid coverage, for example, but healthy, childless adults usually could not.

Under Medicaid expansion, government-funded coverage will be available to everyone below 138 percent of the federal poverty level (income of $15,856 for one person, $21,404 for a family of two, $26,951 for a family of three, $32,499 for a family of four).

Those expanded eligibility limits apply to adults. Children enjoy better coverage. Washington, more generous than some states, already extends Medicaid to children up to 200 percent of poverty level, and for families that pay a small premium, it extends Medicaid to children up to 300 percent of poverty.

In addition to the broadened eligibility, Medicaid expansion makes it simpler and faster to apply for coverage.

Today, it can take up to 45 days for Washington’s agencies to investigate and approve a Medicaid applicant.

To apply for Apple Health, Washington residents will go to a new government website where officials estimate that it will take 20 to 40 minutes, depending on family size, to fill out the form and get coverage. This “Health Plan Finder” website, wahealthplanfinder.org, is the same place where all uninsured Washington residents will be able to shop for 2014 health coverage.

The site begins processing applications Oct. 1. After applicants enter their income information and their inputs are validated against government databases, the site automatically will direct them either to the Medicaid process or the shopping cart for a private health insurance policy.

All Medicaid applicants — current clients as well as new ones — will use this new site. Those who lack Internet access can visit a state office or call a phone assistance line.

Medicaid already covers 103,172 Spokane County residents and 1.2 million Washington state residents.