Sen. Cantwell suggests feds could learn from Washington's Basic Health Plan

TUCKED inside the U.S. Senate's health-care-reform measure is a smart plan by Sen. Maria Cantwell of Washington to spur states into creating public insurance options.

The effort would be modeled after Washington's Basic Health Plan, an efficient provider of health insurance to lower-income residents.

Under Cantwell's proposal, federal subsidies would flow to states that would negotiate with private insurers to provide coverage. There are many reasons why this idea stands out, chief among them the expectation that state efforts buttressed by federal funding will be less vulnerable to the whims of local budget cycles.

The Democratic senator estimates her amendment would provide coverage to 75 percent of the uninsured. This is because only a handful of states, including Washington, Wisconsin and Massachusetts, fund a public plan. Federal funding would help bring other states on board.

Critics of the state Basic Health Plan point to budget shifts, including capping enrollment and increasing premiums. All the more reason to support Cantwell's plan and its promised infusion of federal dollars to gird local efforts.

Washington's Basic Health Plan has been weakened by a 42-percent budget cut imposed by the state Legislature. Currently, 66,000 state residents are on the wait list. We could use the federal aid.

Cantwell's amendment, which is included in the reform bill expected to be passed out of the Senate Finance Committee in the next week, fills a vacuum left by Medicaid, which covers individuals with very low incomes. About 75 percent of the uninsured, however, fall in the working-poor range. Their incomes fall between 133 percent of the federal poverty level — about $12,000 for individuals and $21,660 for a family of four — and 200 percent, which comes out to $30,000 and $44,100, respectively.

Cantwell's plan is not a substitute for a public option but it does create opportunities for the states to cover more of their uninsured residents.