Washington working on unique health care exchange

bshannon@theolympian.comJune 25, 2013 

As national health reform inches along in the states, Washington is pioneering its own health insurance exchange to offer individual policies to consumers, guide some 250,000 newly eligible clients into Medicaid, and line up government tax subsidies for those with low-enough incomes.

So far, it appears the financial outlook is good for Evergreen State consumers whether they plan to buy an individual policy through Healthplanfinder — Washington’s insurance exchange — or get coverage directly through employers.

Most people — 78 percent — “are not going to see an impact” as a result of health care reform, said Stephanie Marquis, a spokeswoman for the Office of the Insurance Commissioner. That is because millions are already covered by large business plans that will continue, by federal programs such as Medicare and Veterans Affairs programs, by Tricare for uniformed military personnel, or through the state-federal Medicaid program that caters to the disabled and poor.

But federal reform makes many changes to the individual and small-group markets. As part of those changes, the Washington Health Benefit Exchange is gearing up to offer vetted insurance policies to consumers, with enrollment in the insurance exchange beginning Oct. 1.

Last month, the state Office of the Insurance Commissioner reported that insurers wanting to sell policies through the individual market were offering premium rates much lower than predicted. Overall, nine firms are asking to offer 57 plans and 229 plan options in the Healthplanfinder exchange.

“Many people will see rates similar to what they’re paying now, or in some cases, lower — and with substantially better benefits,” Commissioner Mike Kreidler’s staffers wrote. And that is before federal subsidies that will defray a share of premiums for some consumers, such as individuals earning less than $45,960 a year and families of four making up to $94,200.

How much an individual pays will depend on the choice of coverage level, the person’s age, and whether the person smokes, Marquis said.

Officials believe premium rates also will be held down for small businesses in 2014, based on rate filings under review by Kreidler’s agency, Marquis said.

“What we’ve seen from the rates so far is promising,” said Bethany Frey, spokeswoman for the Washington Health Benefit Exchange.

The National Federation of Independent Business — which sued to overturn Obamacare — is watching skeptically to see how it plays out.

“It’s a little early, I think, to know for sure how much rates are going to go up,” said Patrick Connor, Washington state director for the NFIB of Olympia. “Businesses, if they have been unable to afford coverage so far, are going to be in the same boat.’’

The state had hoped to open a separate insurance exchange for small businesses — known as SHOP. But few insurers filed proposals, meaning it will be available only in five Southwest Washington counties (which have not yet been publicly identified) in 2014. Most small businesses will have to find their own plans or let employees find policies on the individual exchange.

A tax credit for small businesses offering insurance that was supposed to be accessed through the SHOP will still be available, Frey said. The exchange is working with the IRS to clarify how.

Not providing insurance is an option for those companies with fewer than 50 workers. Steve Neighbors, who serves as chairman of a health care committee for the Association of Washington Business and is on the leadership team of the NFIB, said some small businesses could go that route out of frustration.

“There’s just a lot of confusion,” said Neighbors, who, with his wife, Betty, runs TERRA Staffing Group based in Everett. “I’ve talked to a lot of small-business folks … it’ll just be easier for us to stop buying insurance for employees.”

Their temporary-help agency is finding it hard to sort out what its obligation is to temporary workers, most of whom work few hours and intermittently.

“It’s become a real challenge for us to figure this out,” Neighbors said. “It’s not as easy as you might think.”

The OIC is preparing a page on its website to answer frequently asked questions by business owners and others. Healthplanfinder also plans a public ad campaign to help the public, including business owners, understand the changes. That effort gets underway in earnest in another month, and the exchange agency has formed partnerships with places in counties that will help with outreach.

Olympia’s Choice Regional Health Network is providing that service in Thurston, Lewis, Mason, Pacific and three Olympic Peninsula counties. The Tacoma-Pierce County Health Department is handlingTacoma-area communities.

“I think this summer things will start to get clearer for consumers as we get more information out there,” Frey said. “Our ad campaign will ramp up in a month or so. We’ll be out there.”

Brad Shannon: 360-753-1688 bshannon@theolympian.com theolympian.com/politicsblog

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