Health Care Law Needs Diagnosis

A year ago, the insurance industry hired telemarketers from Kentucky to mobilize Washington state’s business people. Employers were threatened, the telemarketers warned, by government health insurance mandates. Free of charge, telemarketers tranferred the business people to legislators’ phones to file protests. Next, insurance industry lobbyists joined the Legislature’s closed-door negotations and helped write a law, quickly passed, repealing most of 1993’s health care reforms.

Afterwards, an insurance lobbyist crowed that “We took a law that didn’t work and made it into one that did.” Legislators added that 1995’s reforms should keep health insurance costs down, just as 1993’s reforms had begun to do.

So, how’s it going?

Just a few months after 1995’s reforms took effect, health insurance companies proposed massive rate increases - as high as 34 percent. In addition, some want to drop individual insurance policies, by which 400,000 Washington residents get health care. And some employers are trimming their employees’ increasingly expensive insurance benefits.

Insurers complain that the 1995 reforms retained some of 1993’s mandates - namely, bans against old insurance-industry practices of dropping or refusing to insure people who are seriously ill.

It’s plausible that those mandates, detached from 1993’s killed reforms, could drive up insurers’ costs. Here’s why: The affordable way to cover sick people is to allow them in group insurance with healthy people and spread the costs of care broadly. The 1993 reforms authorized group insurance-buying pools, and other routes to universal coverage. But those provisions were killed in 1995.

So maybe it’s no surprise that experience-rated individual insurance became expensive, since insurance companies can’t go back to turning customers away when they get sick.

What’s the solution? One is the state’s underused Basic Health Plan, featuring limited coverage but group purchasing power. Also, insurers may seek repeal of the surviving 1993 mandates. But Insurance Commissioner Deborah Senn says insurance companies exaggerate the cost of those mandates. Even so, if the mandates stay, it’s plausible that health insurance costs would soar. If the mandates go, we’d be left with the pre-1993 system, which yielded soaring rates and dwindling access to care.

Legislators have a duty to develop a third option. If they listen only to the industry’s lobbyists, the record suggests their other constituents - voters - may feel less than grateful, come November. This year, Legislators ought to take a longer look at the public’s interests in the very important struggle to fix our ailing health system.

, DataTimes The following fields overflowed: CREDIT = John Webster/For the editorial board