House Reverses Health Care Reform Lowry Agrees To Compromise; Critics Fear Higher Costs
The state House passed a health care reform bill Monday that virtually repeals the landmark 1993 health care act.
The bill was approved 77-19. It is expected to be signed by the governor this week.
Critics of the new bill noted that the 1993 act was already having positive results, even though it had not yet taken effect. Just the promise of far-reaching reforms had dramatically slowed the growth in medical costs, they said.
Now, they fear, those costs may skyrocket again.
The compromise agreement was worked out by Gov. Mike Lowry with state lawmakers after Lowry became convinced he could not hold onto the reform law.
Health reform supporters praised the 1993 law as a model for the nation. It was nearly identical to President Clinton’s “managed competition” proposal for the nation’s health care system.
But Congress did not provide waivers needed to put the state law into effect. That, combined with a political shift in the Legislature to the GOP, forced Lowry to unravel the 1993 act.
“I’m gravely saddened, but it’s the best we could do,” said Rep. Dennis Dellwo, D-Spokane, who helped write the 1993 act.
Part of the problem, he said, was the 1993 act was so hard to explain.
“We weren’t able to coalesce a group of consumers. The Republicans’ sound bites were ‘pay more and get less.’ But minimum benefit package - how do you put a sound bite in that?”
Rep. Todd Mielke, R-Spokane, said the compromise bill is a step forward for reform and for consumers now free of “government-run health care.”
Opponents to the 1993 act said it created too much bureaucracy, cut benefits while raising costs for many people and involved government too deeply in medical care.
“We have succeeded in putting real health care reform back on track,” said Rep. Phil Dyer, R-Issaquah, who helped broker the compromise. “We have found health care reform that works.”
Rep. Bill Backlund, R-Redmond, said the bill delivers consumers from an “overdose of bureaucracy.”
“This is what the electorate wanted: reform, but not the extreme version of it they got in 1993.”
Opponents worry the compromise will lead to higher insurance premiums.
“Instead of being in the forefront on health care reform, we are now in the back, with the insurance industry in the driver’s seat,” said Rep. Frank Chopp, D-Seattle.
“The only time health care costs leveled off was when there was talk and action on reform. Now those high rates will return.”
Even though the 1993 act never went into effect, health care inflation dropped from 16 percent in 1993 to about 5 percent now, according to the state Health Care Authority.
The health care industry has been restructuring for years, with more customers enrolled in managed-care plans. In those plans, insurers play a role in deciding when a patient will see a doctor.Some said Monday they are con cerned the new bill tips the balance of power even more toward the insurance industry.
“It basically gives the key to the city to the insurance companies,” said Peter McGough, president of the Washington State Medical Association.
Everyone will pay the cost of state
lawmakers’ decision to back away from the commitment to universal coverage, some predicted.
Hospitals that hoped reform would mean timely payments from insured patients will instead be forced to continue passing bad debts along to other patients, said Leo Greenawalt, president of the Washington State Hospital Association.
“Society will continue to expect hospitals to treat everyone,” Greenawalt said.
After six years of work and discussion, the bottom line of the compromise bill is that hundreds of thousands of the state’s estimated 625,000 uninsured will continue to go without coverage, critics said.
“People are going to wake up and realize after all this hoopla, ‘Well gee, I still don’t have health insurance. Gee, my income is still worth less than it was before,”’ said Morton Alexander, Fair Budget Action Campaign coordinator in Spokane.
“Poor people in general are going to lose from this, and poor people more and more include working people.”
xxxx Surgically removed Legislation passed Monday repeals much of the 1993 health reform act, including: The minimum benefits package. The requirement that insurance companies sell only managed-care plans. A cap on premiums. Community rating, in which insurance plans pool health risks in a community when setting rates. The mandate that employers pay half the insurance cost for employees. Health coverage for every state resident by 1999. The new legislation retains: Insurance reforms that outlaw denial of coverage because of pre-existing conditions. Expansion of the Basic Health Plan from 60,000 participants to 200,000 by July 1997. Modified community rating to cut rates for individuals and small businesses.