Gov. Jay Inslee announced on January 8, 2019 that he and Democratic lawmakers will introduce legislation that would provide a public health care option in Washington through the state’s Health Benefit Exchange. Inslee was joined by Sen. David Frockt, Rep. Eileen Cody, Insurance Commissioner Mike Kreidler and King County Executive Dow Constantine. He made the announcement at King County Public Health Center in Seattle, saying Washington has always been a leader in health care.
“Under the Obama administration and the Affordable Care Act, Washington was able to make tremendous progress in expanding coverage and start bringing down costs in our health care system,” Inslee said. “Under the Trump administration, all that progress is at risk. Because of the instability they’ve brought to the system, consumers in 14 counties have only one option for coverage and our ability to rein in costs has been stymied. But we’re going to do all we can to protect health care for Washingtonians. This public option will ensure consumers in every part of the state will have an option for high-quality, affordable coverage.”
The proposal addresses the challenges of health insurance availability as well as affordability. It directs the state’s Health Care Authority to contract with health plans across the state to offer coverage on the Washington Health Benefit Exchange, which guarantees coverage to anyone in the individual insurance market across the state.
It will improve affordability through standardized plan designs that are easier to understand and have lower out-of-pocket costs for consumers. Reimbursement rates would be consistent with Medicare rates for providers that help ensure fair payments for providers and reduces costs for people.
Frockt and Cody intend to introduce the legislation for Washington’s Public Option during the 2019 legislative session which starts January 14, 2019. Frockt said this can counteract President Trump’s recent health care decisions.
“President Trump has done everything in his power to undermine the health care coverage advances we’ve made in Washington,” Frockt said. “The public option will help apply downward pressure to the increases in premiums and deductibles that his terrible policies have led to.”
Washington state has one of the most effective health benefit exchanges in the country. While more than 800,000 Washingtonians have coverage thanks to the Affordable Care Act, the Trump administration has actively undermined the program and removed key mechanisms that helped expand access and keep costs down.
Despite the issues at the federal level, Cody said state leaders are committed to protecting the ability of Washingtonians to get health care at a price they can afford.
“With volatility and uncertainty at the federal level, the goal of this proposal is to provide a sensible alternative that is affordable and accessible in every county,” Cody said. “It’s simple, it’s sensible, and it gives families more choices as they determine the health care that works best for them. And it continues to move us forward in our goal to ensure every person in Washington has health care.”
Sen. Annette Cleveland, chair of the Senate Health & Long Term Care Committee, said she sees health care as a primary issue for Washingtonians.
“Health care is the number one concern in households across our country, and for good reason,” Cleveland said. “At a time when the White House and Senate continue to work to roll back Americans’ health care coverage, it’s more important than ever that we act at the state level to ensure access to affordable, comprehensive coverage for Washingtonians.
How will Washington’s Public Option work?
Every county will have access to an affordable plan that the state will contract for through the Exchange
The Health Care Authority will contract with one or more health carriers to offer qualified health plans on the Exchange. Beginning in 2021, all carriers offering plans inside the Exchange must offer a standard plan at any tier in which they offer at least one plan. Non-standard plans may be offered on the exchange through 2024. Beginning in 2025 only standard plans will be offered on the Exchange.
The public option plans will be standardized to increase consistency of benefits and transparency in costs
Standard plans will have consistent and transparent deductibles, co-pays, and co-insurance, and offer the same services before the deductible. Instead of coverage through plans with various deductibles and cost sharing arrangements, these plans will compete on premium price, provider networks, customer service, and quality. Consumers will benefit by lower deductibles, improved access to pre-deductibles, evidenced-based services across insurers, and access to transparent, predictable cost-sharing.
The public option will help bring down health care costs for patients
The new public option will offer high quality plans consistent with best practices such as the state Health Technology Assessment Program and Medicaid value-based purchasing to ensure lower costs won’t result in lower quality.
Provider reimbursement rates will be capped at Medicare rates, and include cost saving tools such as Health Technology Assessment Program recommendations and Medicaid value based purchasing.
Patients will spend no more than 10 percent of their income on premiums
The Health Benefit Exchange, in consultation with the Health Care Authority, must develop a plan to implement and fund premium subsidies for families and individuals on the Exchange who need financial assistance. The goal is to have consumers spend no more than 10 percent of their income on premiums.