August 30, 2013 in City, Region

2 more health insurers get preliminary OK for WA

By The Spokesman-Review
 

Two more health insurance companies won approval Friday from state Insurance Commissioner Mike Kreidler, to sell policies on the Washington state Health Plan Finder. Required by the federal Affordable Care Act, the Health Plan Finder begins operation Oct. 1 and will be an online marketplace serving individuals who have had trouble getting health insurance coverage.

One of the newly approved carriers, Community Health Plan of Washington, will sell coverage in 26 counties including Spokane, and will address concerns that were raised in recent days on behalf of Medicaid clients who might cycle back and forth between Medicaid and private insurance.

The other carrier, Kaiser Foundation Health Plan of the Northwest, will only sell policies in Clark and Cowlitz counties.

Both companies were among the five firms turned down by Kreidler on July 31, the original deadline for deciding which carriers could sell policies on the new marketplace. Kreidler’s job was to determine whether the proprosed rates were appropriate and the proposed coverage met the standards set in state and federal law.

Addition of Community Health and Kaiser means a total of six insurance companies are likely to be in the competition for consumers’ insurance-buying dollars, when the health plan finder launches, at www.wahealthplanfinder.org.

With 835,000 people lacking health insurance in Washington, and with federal dollars available to reduce the cost of new policies, there’s a considerable amount of business waiting in the wings for health insurance companies to sign up over the next several months.

But one hurdle remains. Insurance carriers also must win approval from the board of the state Health Benefit Exchange, which operates the online insurance marketplace. Knowing that some of the firms Kreidler turned down were appealing, the Exchange’s board postponed its own final decisions until Sept. 4. The holdup put pressure on developers who are working to get the new web site ready. But the U.S. Department of Health and Human Services granted Washington state permission to extend the approval deadline, in the interest of increasing the number of insurance options for consumers.

After Kreidler’s initial decisions, advocates for low-income Medicaid clients noted that none of the approved insurance companies offered Medicaid plans. This could create transition problems, the advocates said, such as a need to find a different doctor when someone’s income rises, making them ineligible for Medicaid and pushing them into the marketplace where they would have to purchase coverage on their own.

Kreidler disputed that complaint, saying that the policies he approved on July 31 offered large numbers of care providers, so that many Medicaid clients could stay with the same doctors and clinics even if they did change from a Medicaid insurance carrier to a private insurance carrier.

Kreidler said that while he knew he would take some heat for saying no to some of the proposed insurance plans, his goal all along has been “to give Washington consumers as many choices of high quality health insurance plans as possible.” He said he was “very pleased” with the plans he now has approved.

With Community Health, his objections had involved a two-tier pricing structure, which the carrier agreed to drop. Under Washington law, he explained, “charging different co-pays for the same type of provider can look like discrimination, steering lower-income residents to only certain providers. CHPW fixed this issue.”

Community Health already operates in the state, providing policies to Medicaid clients as well as policies under Medicare Advantage Plans. According to its web site, its provider network includes the Spokane-area CHAS clinics, which provide medical care for low-income people. As a result of Kreidler’s decision, Medicaid clients with a Community Health Plan will be able to stay with Community Health, if they wish, if their income rises and makes them ineligible for Medicaid. They could replace their Medicaid plan by purchasing private coverage from Community Health, from the Health Plan Finder.

© Copyright 2013 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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