The Washington House voted 53-38 on April 10 in favor of a Senate bill purported to lower health care costs, while detractors argued prior to the vote that it will have the opposite effect. ESSB 5526 is the companion bill to HB 1523, which cleared the House 57-41 on Mar. 8, and as of April 9 had been referred to the Senate Rules Committee.
Before the April 11 House floor vote, Rep. Richard Debolt (R-20) argued that the bill represents the latest encroachment by the state into managing the health care industry. “What we have done is we’ve pulled competition out, and this bill takes the last inkling of that away.”
Rep. Jim Walsh (R-19) said that “efforts at both the federal level and the state level to improve access to health care…. has in fact been the opposite. I’ve got one of those counties in my district that almost went bare recently, had no one willing to offer individual coverage through the exchanges.”
Currently, the Washington’s Health Benefit Exchange enables people to compare and purchase individual health coverage through private carriers by selecting from four tier plans: bronze, silver, gold and platinum. Those plans cover a certain percentage of the “actuarial value,” while the insurance provider covers the remaining costs.
ESSB 5526 directs the Health Care Authority (HCA), the insurance commissioner and others to develop standardized plans for those tiers, with structured deductibles, premiums and a set number of visits to various health care providers. The health care exchange would be allowed to update those plans on an annual basis. In order to qualify for the health exchange, insurance carriers would have to offer at least one standard silver plan and one standard gold plan, which represent 70 and 80 percent, respectively, of the actuarial value.
Rep. Nicole Macri (D-43) said that the bill “will provide more competition in the market and plans that consumers can understand. This is an important step for the people who we know are struggling the most to get health insurance that they can actually use.”
The bill also directs the HCA, the exchange and the insurance commission to develop and fund premium subsidy plans for individuals with gross incomes less than 500 percent of the federal poverty level. As of 2018, an individual would have to make less than $60,700 in annual gross income.
“We’re no longer providing care to the indigent,” Walsh said on the House floor. “We’re no longer providing subsidized care to people from poverty; we’re doing something to try to redesign the entire method of delivering health care services, and that is not something that we in this chamber frankly are good at. I’m concerned that our efforts here will only continue the problem.”
“Hospitals don’t support this, providers don’t support this, and the carriers don’t support this,” Rep. Joe Schmick (R-9) said. “I am disheartened for the simple fact that…. this is about reducing costs, and yet nothing is in there to look at the cost drivers.”