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Washington State's Basic Health Plan: Choices and Challenges

The current turbulence characterizing the health sector has engendered a limited number of state-level experiments to provide health services for the nation's 37 million uninsured. The issues and challenges generated by each program's design and implementation vary. By examining the experience of one such state program, the Washington Basic Health Plan, in some detail, this paper contributes to the policy debate regarding the possible range of solutions available to address the issue of “the uninsured.” By analyzing the array of design choices available at the time the program was enacted, and why certain options were chosen rather than others, this paper points to the complex interaction of political dynamics, public policy development, and program implementation.