Individuals should be in charge of their health insurance and care needs. Our focus remains on consumer-driven health insurance plans that ensure Washingtonians have options that fit their needs. Increasing the role of government in the patient-doctor relationship is not the direction we believe is best for patients and their doctors.
- Flexibility for consumers to design their own health care plans with a minimum of state mandated coverages;
- Allow for Association Health Plans to allow small employers to pool with other employers around the nation to increase purchasing power and lower premium costs for their employees;
- Allow consumers to purchase health insurance across state lines;
- Protect our Critical Access Hospitals to ensure prompt emergency care in the rural parts of our state;
- Ensure doctors and patients, not government, make decisions that offer the best care; and
- Reign in frivolous lawsuits so doctors do not have to perform “defensive medicine” that leads to higher costs that are passed along to patients through higher premiums.
National Health Care Reform and Washington’s State Health Insurance Exchange:
As this state and nation moves away from the private health insurance marketplace toward a government-centric health insurance model mandated through National Health Care Reform, we fear Washingtonians may be unable to find a doctor to care for them. The reasons are many:
- Health insurance does not, on its own, guarantee health care for patients;
- Lower reimbursement rates to doctors has already lead to fewer physicians accepting Medicare (government-subsidized) patients;
- A one-size-fits-all approach to health insurance plans;
- More patients on the Medicare rolls with fewer doctors accepting those subsidized patients;
- A shortage of doctors in the state and nation; and
- Confusion about what treatments will be approved or denied under the new national and state health insurance plans.
If done correctly, an Exchange could benefit individuals and employers by being an insurance market “organizer” and providing individuals with more health insurance choices and the ability to take their health insurance with them should they change jobs. However, an Exchange can also be designed as another “regulator” of health insurance which will limit health insurance choices and increase the costs of health insurance.
Now that Washington is committed to the State Health Insurance Exchange, our focus must be to give consumers affordable options, ensure lower insurance premiums and create a system that is accessible and efficient.
Facts about the state and federal health insurance and care changes:
- Washington state is one of the first states to authorize a Health Insurance Exchange (Exchange) under Federal Health Care Reform through passage of Senate Bill 5445 and House Bill 2319.
- Currently, only 14 states have decided to establish a state-based Exchange and two additional states, Massachusetts and Utah, created one prior to Federal Health Care Reform.
- Federal Health Care Reform will provide subsidies to purchase health insurance through the Exchange to families earning less than 400 percent of the federal poverty level (FPL), or $44,680 for a single individual and $92,200 for a family of 4, and those who are ineligible for Medicaid.
- Individuals earning more than 400 percent FPL and small businesses will have the option of purchasing health insurance through the Exchange.
- States may establish and operate their own state-based Exchange or, if a state chooses not to establish an Exchange, the federal government will operate one either directly or through an agreement with a non-profit entity.
- Office of the Insurance Commissioner (OIC) will now have more regulatory authority over health insurance offered both inside and outside the exchange by requiring rules related to any additional benefits. The first OIC draft rules were 22 pages, and the OIC publicly stated there will be “premium shock” in 2014, especially in the individual, non-group market.
- Exchange staff estimates it will cost approximately $50 million per year to operate the Exchange beginning in 2015. This translates to an additional cost of $11-$22 per month for health plans purchased through the Exchange.
Follow legislative action affecting health care: