August 31, 2013 in City

Two more insurance companies approved for exchange

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. Community Health’s approval will address concerns raised in recent days on behalf of Medicaid clients who may want the option of purchasing private coverage with the same insurance carrier they had under Medicaid. 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 proposed 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 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 many new policies, a considerable amount of business waits in the wings for health insurance companies.

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 companies Kreidler turned down were appealing the decision, 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 website ready by Oct. 1.

After Kreidler’s initial decisions, advocates for 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 to purchase coverage on their own.

Kreidler disputed that complaint, saying that the policies he approved 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 switch insurance carriers.

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.”

Community Health already operates in the state, providing policies to Medicaid clients as well as Medicare Advantage Plans. According to its website, its provider network includes clinics of the Community Health Association of Spokane, which provides medical care for low-income people.

Because of Kreidler’s decision, Medicaid clients with Community Health policies could choose to stay with Community Health by purchasing a subsidized plan on the Health Plan Finder if an increase in their income makes them ineligible for Medicaid.


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