Republican state Sen. Randi Becker hasn’t always liked the decisions of the state Office of the Insurance Commissioner or answers that she and constituents have gotten from its boss, state Insurance Commissioner Mike Kreidler. In one case that hit close to home, Becker said a decision by Kreidler’s agency – in approving a generics-only insurance plan – led to the company eventually dropping drug coverage.
“Well, that affected my brother who is a cancer survivor, and so he had to pay out of pocket for all of his medications,'' Becker said this week, adding that she heard from constituents who also were upset by that move. "I look at some of the things over the history and I look at my time down here. And I look at the times I feel he (Kreidler) doesn't listen to the people.''
With that in mind, the second-term lawmaker from Eatonville filed a bill to get rid of the OIC altogether. She would replace the elected commissioner’s office with a 10-member health board in January 2015, two years before Kreidler's term expires.
The board would have representatives nominated by the Legislature’s four caucuses and picked by the governor. The board members would reflect interests or expertise – including an insurance specialist, an economist, a consumer advocate and a small business person.
Becker plans a public hearing on Senate Bill 6458 at 10 a.m. Monday in the Senate Health Care Committee, which she chairs, and a vote by the Feb. 7 deadline.
Kreidler said he isn’t sure he’ll attend the hearing. But the four-term Democratic commissioner said he takes the Legislature’s actions seriously and he thinks that consumers would lose a strong regulatory advocate if the system is changed.
Becker said in an interview that she wants to pattern the new regulator after the Washington Health Benefit Exchange, which the Legislature authorized two years ago to operate Healthplanfinder. The online exchange is in response to federal health reform, and Becker thinks the exchange agency has done a good job.
"We really looked for a way to get it so everybody felt represented,” Becker said of the exchange, which has members from business, labor and other interests. “We set the board up to where it's nominations from the House Ds and Rs, and nominations from the Senate Ds and Rs. “
Becker’s proposal to restructure the insurance agency is not the only one big government restructuring sought by Republican members of the Senate Majority Coalition Caucus. Others upset by a court order on school funding want to reduce the number of justices serving on the state Supreme Court.
Still others upset by a decision on a Democratic donor to a Senate campaign last fall want to let the Legislature appoint members of the Public Disclosure Commission, which regulates campaign finance, instead of letting the governor make appointments.
Kreidler said he was caught by surprise when Becker introduced the bill.
“I can tell you right now – you don’t have an example of this any place in the country that operates that way. This would be unprecedented,” Kreidler said. “If you’re in the insurance industry, you’re rubbing your hands. This is a way to keep the regulator from being able to act aggressively to protect consumers. … That is a recipe for the insurance industry to make sure whatever happens is in their best interest.’’
Kreidler also took a slap at the board structure for the Washington Health Benefits Exchange, which is technically not a state agency. He said he supports a proposal from Rep. Eileen Cody, D-Seattle, to put the exchange directly under the Governor’s Office, making it more directly accountable to a single pressure point. Cody plans a hearing on HB 2340 in the House Health Care and Wellness on Monday.
Kreidler also defended his agency’s handling of the generic drugs situation in mid-2012. He said his office had approved a health carrier’s insurance plan that limited coverage to generic medications. Once it came to light that the policy was discriminatory – in not allowing brand-name drugs in cases where patients could not be helped by a generic – Kreidler required that the prescription coverage also include brand-name drugs when medically necessary.
But the insurer, LifeWise, dropped all coverage of medications, which was not required under the law for individual policies at the time. Kreidler’s office says that LifeWise and its parent firm Premera could have kept the amended prescription coverage at a cost of about 7 percent more on premiums. Instead the insurer dropped all coverage, which Kreidler suspected the insurer wanted to do anyway.
Becker says Kreidler should have put insurers on notice they would have to change the policy at the next renewal date.
That isn’t the only complaint Republicans in the Senate have had about Kreidler. The GOP has been outspoken about the commissioner’s refusal to take President Obama’s offer last year to help those who got cancellation notices for their health plans – some of them as a result of new requirements under the Affordable Care Act. They say 290,000 consumers lost coverage, and it’s unclear where those uninsured ultimately got coverage, if at all.
Obama was under pressure nationally for having promised that the ACA would let people keep their plans if they liked them. So he offered to grandfather in plans, if state commissioners would allow it.
Kreidler says he refused to let in the old plans because they were substandard, failing to cover prescription drugs in some case.
He said his office is trying to learn what happened to those who got notices and has issued a “data call” asking insurers to provide details on who is covered and who lost coverage.