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Spokane, Washington  Est. May 19, 1883

Washington insurance commissioner calls GOP plan to replace Obamacare ‘a step backward for millions’

Dr. Sam Schneider tends to a patient at CHAS Health urgent care facility in Spokane on March 2, 2015. CHAS Health expanded its primary care offerings during the ACA years. KATHY PLONKA (Kathy Plonka / The Spokesman-Review)

Washington Insurance Commissioner Mike Kreidler found plenty to criticize in the GOP plan to replace the Affordable Care Act on Tuesday, calling the proposal “a step backward for millions of people who have gained coverage.”

In a statement released by his office, Kreidler also criticized Republicans’ plans to remove the mandate requiring individuals to have health insurance. He said removing the mandate could cause insurers to “flee the market” if not enough healthy people buy insurance.

Kreidler’s remarks came as health care providers, state regulators and insurance companies began analyzing the 123-page plan to replace ACA, also known as Obamacare. Much of the initial reaction focused on an expected drop in the number of people with health insurance, and the potential for turmoil in health insurance markets.

Kreidler said replacing income-based subsidies for purchasing insurance with tax credits puts poor residents at risk of losing coverage. Kreidler was also critical of a provision that allows insurance companies to charge older customers up to five times more than younger customers. Under the ACA, insurance companies could charge older customers up to three times more.

Kreidler also called a provision to make plans that offer abortions ineligible for tax credits “a direct attack on women’s rights” and more costly in the long run.

Kreidler said he was concerned that the measure was being rushed to a vote with little time for public review or a financial analysis by the nonpartisan Congressional Budget Office. His office is working on a detailed review of the ACA replacement, which it plans to release early next week.

“There are big chunks of information that are still missing,” which makes it difficult to judge the impact of the ACA replacement, said Mary Kay Clunies-Ross, spokeswoman for the Washington State Hospital Association.

However, the association’s priority is keeping insurance coverage for more than 700,000 Washington residents who gained it under the ACA, she said.

“The lens we have been looking at all these proposals from the beginning is, what will be the effect on coverage,” she said. “You can’t get to a healthier community without access to health care services … and you can’t get to access without coverage.”

From that perspective, “we definitely have concerns about what we’re seeing thus far,” Clunies-Ross said.

If people don’t have health insurance, they’ll be back to getting treatment in hospital emergency departments instead of clinics, she said.

Hospitals are also concerned about potential disruptions to insurance markets, Clunies-Ross said.

“Our read on this replacement is that there is a lot more uncertainly and instability,” she said. “It makes prices go wiggy. That makes it harder for providers, physicians and hospitals to plan.”

Premera Blue Cross, one of the state’s largest insurers, is still analyzing the plan, said spokeswoman Melanie Coon.

While Coon said she couldn’t comment directly on the proposal, she said Premera “supports solutions that really encourage people to purchase coverage and keep coverage and not come in and out of the marketplace.”

The stability of a large pool of customers, including healthy clients, helps keep rates stable, she said.

“Our goal is to have a stable transition no matter what gets decided … with minimal disruption to benefits and access to care,” Coon said.

Better Health Together, a subsidiary of Empire Health Foundation in Spokane, has focused on helping uninsured residents get coverage under ACA. More than 60,000 Spokane County residents qualified for health insurance subsidies or were able to get health insurance through Medicaid expansion in Washington.

Curt Fackler, a manager at Better Health Together, said he’s still reading through the fine print on the GOP plan and can’t offer an opinion yet.

However, “We want to make sure that the Medicaid expansion stays in Washington. We want to keep the progress we’ve made in getting people insured,” he said.

Continuing coverage for the newly insured is the issue that will dominate the debate in Congress in the coming weeks, Fackler predicted.