Basic Nightmare

How budget cuts and poor planning made life miserable for the state's poorest.

As Congress continues to fight over Obamacare, this state is yet again slashing the program Governor Chris Gregoire last year called "the model for the rest of the nation." Budget woes prompted the legislature last month to cut undocumented immigrants from the Basic Health Plan, which provides subsidized care to low-income Washingtonians. But many of the more than 15,000 immigrants who received disenrollment letters were, in fact, citizens or legal residents, acknowledges Basic Health director Preston Cody. Because Basic Health had never before required proof of immigration status, the program didn't have Social Security numbers on file for many of its members. Ideally, Cody concedes that the program would have requested documentation before sending out disenrollment letters. But Cody maintains the program didn't have time for that. The legislature had cut $9 million of its funding and told administrators to toss off some seniors, kids, and those making over 133 percent of the federal poverty level, all of which resulted in another 1,600 disenrollment letters. And Basic Health didn't have the money to keep everyone on the rolls while it sorted things out, he says. Instead it used the information it had and counted on its appeals process to correct mistakes. The result: massive confusion. Some immigrants didn't even understand the letters they got, which were written in English and Spanish. Teresita Batayola, executive director of the nonprofit International Community Health Services, says her staff was "deluged" with translation requests from Asian, East African, and Eastern European patients. Others contacted the program immediately to protest. "The first couple of days, we received thousands" of appeals, Cody says. Unexpectedly for the program, many were justified. As of Friday, Basic Health had reinstated two-thirds of the 5,900 appeals it had heard. Often, those appealing were able to produce a birth certificate or passport proving their citizenship. "That's far greater than anticipated," Cody says, adding that initial figures assumed only 10 percent would successfully appeal. This means two things. While a lot of people like to talk about the costly benefits illegal immigrants are getting, such immigrants aren't quite the drain—at least in terms of Basic Health—that even bureaucrats thought they were. Or should we say hoped they were. Because the ability of many Basic Health members to prove their legal status also means that the state is going to save less money than it thought. Cody says his program will let the legislature know that this budget problem, like so many others, is not yet solved.

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