What happens when you cut the budget for Washington's Basic Health Program—which covers nearly 100,000 working poor residents of this state—by 43 percent?

We're about to find out.

According to the Washington State Health Care Authority, which administers the program, the possible routes for getting in line with the new, $238-million-lighter budget imposed by Governor Christine Gregoire were all bad. As Steve Hill, the agency's administrator, said today in a statement:

The options included providing coverage to only the lowest income members, cutting off members based on their time with the program, or a lottery.

A lottery.

Instead, what Hill came up with is a rate increase. Currently, those who make it in to Basic Health—the waiting list is some 30,000 people long—pay a percentage of the monthly premium based on their salary. Most people in the program pay around $36 a month, with the state picking up the rest of the $245 monthly tab.

Under the strategy announced today by Health Care Authority Administrator Steve Hill, the average enrollee will pay $61.60 [per month] in 2010. The $150 annual deductible will also increase to $250 on January 1, 2010.

Hill says this was the only way to keep from "arbitrarily" removing people from the program, and that he'll try to make more room in Basic Health by removing about 5,000 people from the program who are currently covered by Medicaid (and perhaps another 3,000 people who may qualify for Medicaid).

"We are fully aware that this decision will impact many people in the program," Hill said in the statement. "Even a $17 a month increase can be tough for a family struggling to get by. But this option gives those families a choice."

That is, if they have Medicaid coverage or can afford the rate increase. If not, there's not much of a choice except to join the more than 46 million Americans who are already living without health insurance.

Photo via Creative Commons and Flickr user Frankieb.

If you're trying to figure out whether reform of America's busted healthcare system is finally, really, truly going to happen this year, this fantastic piece by Matt Bai in yesterday's New York Times Magazine is required reading.

It looks at how President Obama—between trying to achieve Middle East peace and save our floundering economy—is planning to move major healthcare reform through the labyrinth of self-interest, lingering grudges, and lobbyist influence that is Congress. It's a goal, Bai notes, "that has eluded every Democratic president since Harry Truman."

More on that later, but here's one fascinating item. While no one agrees on where, exactly, Congress is going to get the money to pay for a shiny new American healthcare system, one idea is to tax your favorite sugar-bomb soda. Or, as Bai put it:

Slap new taxes on some of the products that cause health problems in the first place, like soft drinks.

Of course, he notes, "industry lobbyists are already spending satchels of cash to head that off." But while they fight that one out, it seems worth considering what other delicious personal-health timebombs the government might want to tax, and what proven cures it might want to subsidize, in order to make healthcare reform more affordable:

What's universal healthcare worth to you?

Photo via Creative Commons and Flickr user woody1778a.