The number of people without health insurance in Washington has climbed over the last decade, even during economic upswings. At the same time, enrollment in Washington’s Basic Health Plan has fallen dramatically, the  result of several years of compounding state budget cuts. Today, Basic Health covers only 35,000 residents, and more than 157,000 are on the wait list due to shortfalls in state funding.

In 2014, the Affordable Care Act (ACA) will ensure health care for all those covered by Basic Health. In the meantime, lawmakers may choose to maintain Basic Health through 2013. However, mere maintenance will not address the  failure of the private insurance market to provide coverage to growing numbers of Washington residents.

There is a better alternative – one that expands Basic Health coverage without raising new revenue: The legislature  can authorize the state to issue revenue bonds for a portion of the Tobacco Settlement revenues. Doing so will enable Basic Health to cover more than 130,000 people – including the majority on the current wait list – as Washington  voters originally intended.