WAHBE leadership joins conversation on a public health insurance option

Health insurance affordability was the focus of contributions made by the Washington Health Benefit Exchange at State of Reform’s annual Health Policy Conference held in Seattle on Jan. 10.

Joan Altman, Associate Director of Legislative & External Affairs for the Exchange, joined a panel that included Rep. Eileen Cody, Lonnie Johns Brown from the Office of the Insurance Commissioner and Andrea Davis of Coordinated Care to discuss policy-driven options for addressing challenges related to lowering the cost of coverage.

The discussion held by the panel, titled “The Politics of a Public Option or Medicaid Buy-In,” was motivated by recent trends identified in the individual insurance market.

While the overall number of Washingtonians without health insurance coverage has dropped by more than 60 percent in the seven years since the Affordable Care Act was first enacted, more immediate data reveals a slight decline in that progress. The past two years alone have seen 35,000 fewer residents purchase individual health insurance coverage, both on and off the Exchange.

“The uninsured rate has dropped dramatically since the introduction of the Affordable Care Act,” Altman said. “We’re now at risk of moving in the other direction.”

The panel pointed to affordability as a primary concern for customers who forgo coverage. Premium costs increased by 13.8 percent in 2019 after a 24 percent rate hike in 2018. Compounding those increases are high deductible payments that may be causing some customers to question whether their coverage is worth the steep premiums.

Plan complexity, loss of the individual mandate and the increased availability of short-term coverage offered outside of the Exchange were cited by the panel as additional factors preventing the individual market from stabilizing.

A public health care option is a lever intended to reverse that course. By offering a government-provided health insurance plan, purchasing power could be leveraged to help lower prices for consumers. The panel proposed that the structure of a public option in Washington state could take on two different forms:

• Offering a new health insurance product that competes with the private plans available in the Exchange.
• Expanding an existing program to establish something like a“Medicaid Buy-In” or “Medicare Buy-In.”

Gov. Inslee announced earlier in the week that Rep. Cody and Sen. David Frockt plan to introduce public option legislation once the 2019 legislative session begins on Jan. 14. Among other considerations, Rep. Cody emphasized that any public option proposal should increase affordability while providing access to meaningful coverage and maximizes available federal subsidies.

“We want to make sure the individual market is available across the state, that it’s affordable and that it’s a product customers can actually use.”