The Seattle family of Jason Potter and his wife Ralitsa and daughter Julia are relying on a patchwork of health care after the state cut back on its health insurance program of last resort. Photo by John Keatley/Redux

Jason Potter was working for an architecture firm in Europe when the economy collapsed. He came home to Seattle with a Bulgarian wife, a toddler and $100 in his pocket.

With no money and little demand for architects, Potter, his wife Ralitsa and baby Julia have been staying with relatives.

While out of work, Potter had hoped to enroll in the Basic Health Program, the state-funded low-cost health insurance plan. But the program already has a waiting list of 18,000 and isn’t taking new applications. And now Basic Health must shed 40,000 people from the existing rolls of more than 100,000—victim to the $9 billion deficit that legislators balanced by slashing spending on health care and education.

Potter and his daughter qualify for Medicaid but his foreign-born wife does not. For now they’re using a local medical clinic run by Neighborcare Health, a nonprofit which gets revenue from Basic Health,
Medicaid and others. Ralitsa Potter must wait about a month to be seen by a doctor for routine care.

The cuts to Basic Health will mean even longer waits, said Mark Secord, Neighborcare Health’s CEO. He expects to lose state reimbursements of $500 to $600 per patient. To make up an expected loss of a half-million dollars, Secord said he will have to eliminate nursing, mental health, and administrative positions, creating more of a burden on the rest of the medical staff. Besides increased wait times, patients will have no financial help with prescriptions.

“Without the Basic Health Program, patients are on their own if they need hospitalization, expensive drugs, or specialty care,” Secord said. “Imagine being in the middle of cancer treatment, or scheduled for surgery, or being immediately post-op.”

Ingrid McDonald, AARP Washington advocacy director, had hoped lawmakers would use more ingenuity to mitigate the cuts.

“They didn’t maximize the opportunity for federal dollars or find other innovative ways to expand revenues,” she said. “Now we are faced with deep cuts that will put some of the most vulnerable people in our society at great risk and will swell the ranks of the uninsured.”

Other state programs were also cut to balance the budget. Funds were cut by 70 percent for the Adult Day Health program, which provides nursing and personal services to older and needy people. In addition, home aide hours were cut by 3 to 4 percent. That will make it harder to keep family members out of nursing homes. “These cuts are penny-wise and pound-foolish,” McDonald said, “because nursing home care is more expensive to the state than paying for home care.”

Gov. Christine Gregoire, D, said these cuts would be “inconceivable” in normal times and blamed the economic crisis. “No one likes this budget, nor are we indifferent to the impact the hard choices that were made will have on the lives of people and their families,” she said.

Under pressure from AARP and other organizations, lawmakers backed away from some of the proposed cuts that would have harmed the most vulnerable. By preserving the state’s copayment program for Medicare Part D, very low-income seniors and others with disabilities will continue to have coverage for prescription copays. Vision, hearing and dental coverage for Medicaid recipients was also preserved.

Potter’s return to his recession-pinched country from a developing nation has been a culture shock. “Bulgaria’s health care is like a big MASH unit,” he said. “They boil and reuse glass syringes, and they use milk bottles for IVs. But at least everyone has access to it.”

L.D. Kirshenbaum is a West Coast editor for NewsPlink.com.