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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Report backs health reform

Uninsured population projected to grow without law

Washington’s top insurance officials warned last week that undoing federal health care reforms will exacerbate the financial problems tied to growing numbers of uninsured residents.

More than 1 million residents now lack health care coverage in the state. The number will grow to 1.1 million in 2013 if the U.S. Supreme Court strikes down reform, according to a report released by Insurance Commissioner Mike Kreidler.

The Supreme Court heard arguments over the constitutionality of the Patient Protection and Affordable Care Act that President Barack Obama signed into law in 2010, and the court is expected to issue a ruling this month. It promises to be a core issue in this year’s presidential campaign.

Kreidler’s report found that if the law stands, more than 800,000 Washington residents will be eligible to tap government programs and gain coverage. Many of the rest would be required to obtain insurance without government assistance, either through individual plans or through their employers.

About 328,000 would become eligible for Medicaid, the state/federal partnership that provides medical coverage for the poor. Another 477,400 people would be rolled into a program that subsidizes health insurance premiums.

In Spokane County, there would be 20,100 more people eligible for Medicaid coverage, and another 40,300 would qualify for policy premium subsidies, Kreidler’s report noted.

His report concluded that 15.2 percent of Spokane County residents are uninsured, or 73,200 people. Island County has the lowest percentage of uninsured population, at 12 percent, followed by Thurston County, the seat of state government, at 12.1 percent. Yakima County has the highest uninsured population, at 30.8 percent. Critics of the health reform legislation say that the individual mandate requiring eligible people to buy insurance – including those receiving a government subsidy to help offset the cost – is unconstitutional. And they say reforms apply onerous regulations on health care providers and will cost a debt-ridden government billions more each year.

Washington Attorney General Rob McKenna, a Republican and gubernatorial candidate, joined the 26-state challenge to the law.

Kreidler is a Democrat and former congressman.

Hospitals such as Providence Sacred Heart Medical Center and Deaconess Medical Center have been complaining for years that their financial security is being eroded by charitable care provided to the poor and bad debts that have to be written off because uninsured patients cannot afford increasingly expensive care.

Since many uninsured patients don’t have a personal physician, they turn to emergency rooms when their medical problems grow severe enough to warrant care.

The problems have led to changing business strategies among Spokane’s largest health care providers.

Providence as well as Rockwood Health System, which operates Deaconess, have been acquiring clinics in a new business model that seeks to treat people earlier and less expensively.

Dr. Kevin Sweeny, who leads physician recruitment at Providence, the region’s largest hospital system, said cost containment is driving clinics and hospitals regardless of reforms.

As for federal health reform, Sweeny said, “For the most part, I think that Providence remains neutral in this debate.”