Health & Wellness - Enrollment in Public Health Coverage

Enrollment in Public Health Benefits Coverage

Healthcare access is, for the most part, unattainable for low-income families not already receiving financial support services or whose household income is used to pay a disproportionate amount of their household income on housing costs and other basic needs. Additionally, having public health benefits does not guarantee access. Currently in Pierce County there are 6.4 Medicaid physicians for every 1,000 Medicaid clients.

The Washington State Department of Health reports that:

17% of adult Pierce County residents do not have health insurance; and that,
14% of adults reportthat they needed to see a doctor in the last year but could not due to cost

Source: Washington State Department of Health, Behavioral Risk Factor Surveillance System 2004-2006

Combined, the DSHS administered public health benefits and Washington Basic Health provide healthcare access to 129,069 or 16.03% of all Pierce County Residents.

DSHS Medical Assistance Administration currently includes programs groups that include Children’s Medical Program, Family (TANF) Medical, People with Disabilities, Elderly People, Pregnant Women’s Coverage, Medicare SLMB Beneficiaries and Family Planning.** State Fiscal Year (SFY) 2009/10 ended with almost 160,000 enrolled in DSHS administered health benefits, up 6.14% and the biggest single year increase since SFY03.

Source: Washington Department of Health and Social Services Medical Assistance Administration

Washington Basic Health is not included in the data supplied by DSHS. Washington Basic Health is currently administered by the Washington Healthcare Authority. August of 2007 serves as a benchmark for enrollment when there were 7,973 total enrollees, of which 12.1% (967) were age 0-18. In November of 2008, there were 8,147 individuals enrolled in Basic Health. Numbers have continued to decrease, and in November of 2010 only 4,248 people were receiving subsidized healthcare (a 48% decrease).

Basic Health Subsidized Enrollment Age Regardless of Dependent Status (Source: Washington Healthcare Authority)
Coverage Date	County	Age 0 -18	Age 19 and Over	Age Unknown	Total Enrollment	0 -18 Percent Total County
Jul-07	Pierce	950	7,006	-	7,956	11.9%
Aug-07	Pierce	967	7,006	-	7,973	12.1%
Nov-08	Pierce	754	7393	-	8,147	9.3%
Nov-10	Pierce	149	4099	20	4,248	3.5%

Source: Washington Healthcare Authority

Combined, the DSHS administered public health benefits and Washington Basic Health provide healthcare access to 121,178 or 15.3% of the low-income Pierce County Residents.

**Children's Medical Program includes children financed by Medicaid (Title XIX), State Children's Health Insurance Program (SCHIP) and state-only financed coverage for children that do not qualify for Medicaid or SCHIP. Family (TANF) Medical includes people enrolled in the Medicaid Family Program (TANF households, households eligible for TANF but only receiving medical coverage, and households in transitional medical assistance), Refugee Assistance, and Medicaid Medically Needy (MN) other coverage. "People with disabilities" includes people enrolled in Medicaid Categorically Needy (CN) blind/disabled coverage, CN Health Care for Workers with Disabilities, Women with CN breast or cervical cancer coverage, MN blind/disabled, GAU clients receiving Medical Care Service (MCS) coverage, ADATSA clients receiving MCS coverage, and persons receiving inpatient psychiatric coverage. "Elderly People" includes people age 65 and older enrolled in Medicaid CN elderly coverage and MN elderly coverage. "Pregnant Women's Coverage" includes women enrolled in Medicaid's pregnant women's program and Title XXI financed coverage for pregnant women. "Medicare SLMB Beneficiaries" includes Medicare beneficiaries with incomes between 100% and 120% of the federal poverty level and receive Medicaid coverage for their Medicare Part B premium costs. "Family Planning" includes women receiving post-partum family planning coverage and persons receiving "Take Charge" family planning coverage