You are currently viewing all posts written by Carol M. Ostrom.
December 3, 2013 at 7:00 PM
Washington Insurance Commissioner Mike Kreidler, who refused President Obama’s offer to let people keep discontinued health plans, will testify before the U.S. House Ways and Means Health Subcommittee early Wednesday morning about how the Affordable Care Act is working in Washington.
Kreidler was invited to testify by Rep. Jim McDermott, a Democrat from Seattle, who serves as the ranking member on the subcommittee.
Kreidler, a Democrat, may face some uncomfortable questions from some subcommittee members, some of whom are hearing from disgruntled constituents whose insurance plans were pulled because they didn’t meet the ACA’s requirements.
The New York Times noted a “fresh wave of legal challenges” to the law, as well as a hearing to be held by the House Judiciary Committee to examine whether President Barack Obama is properly using his executive powers to alter provisions of the law. The committee also will examine the theory behind the lawsuits — that tax credits or subsidies cannot be granted to people who purchase insurance through the federal exchange.
Washington is among a minority of states with its own state exchange.
About two-thirds of the 290,000 Washington residents who currently buy individual insurance plans were covered by “catastrophic” policies with limited benefits, the state insurance office says. Most of them learned this fall that their policies were being discontinued.
The discontinued plans likely insure healthier people, since insurers formerly could reject people with health problems. Kreidler, and insurers generally, said that allowing the discontinued policies to continue — and to keep those policyholders out of the marketplace — could disrupt the stability of the market, since insurers carefully priced plans based on projections of the health of their enrollees, among other things.
In addition, letting people keep “bare bones” plans, Kreidler said, was not in keeping with the consumer protections of the Affordable Care Act, which mandated coverage of such areas as prescription drugs and maternity care.
The hearing, at 7 a.m. PST, will be streamed live; to watch, click here.
December 2, 2013 at 6:04 PM
Anticipating the coming wave of patients under the Affordable Care Act, Group Health and Bartell Drugs are building three in-store, walk-in retail clinics in Seattle, Bellevue and Ballard. The clinics will be open to the general public and charge a set price for minor illnesses and treatments for common injuries.
The “CareClinics,” staffed with Advanced Registered Nurse Practitioners (ARNPs), will charge $75 per visit for a list of common conditions, including colds and flu, sinus infections, allergies, burns, rashes and cuts, pinkeye, sore throat, head lice, warts, sprains and strains, bronchitis, ear infections and urinary-tract and intestinal infections. Care is available to patients age 2 and over.
The clinic will collect co-payments and bill most insurers for non-Group Health members, and create an electronic medical-record file through Epic, the most commonly used type of system, that can be forwarded to a patient’s primary-care or specialty provider, said Dr. Wellesley Chapman, medical director for the clinics. The idea is to make it convenient and easy for the customer, he said, an concept more common in the retail world than in health care. ”I think we can agree that health care in general is not built around customer service,” he said.
The first site is slated to open in mid-January at Bartell Drugs in University Village. In the next two months, the partnership plans to open clinics at Crossroads in Bellevue and at a new Bartell Drugs in Ballard.
Patients have said they want more choices and more transparency, said Group Health President and CEO Scott Armstrong, who said the clinics are “a sensible extension of the things we’re doing well already.”
Too many patients go to emergency rooms for simple problems that could be easily treated at such a clinic, he said, and a many are admitted for problems that were preventable. “If your goal is to advance the overall health of a population of patients, then you should be doing exactly what Group Health is doing,” he said.
Helen Neville, Bartell Drug’s senior vice president of marketing, said her company, like Group Health, has long valued customer service. And customers were saying they wanted more options for convenient access to health care. “This is the right idea and the right partnership.”
The clinics likely will be open the same hours as the in-store pharmacies, and decisions about expanding the program will be made after a six-month evaluation, the two companies said.
In early January, the partnership will launch www.care-clinic.org for more information.
November 15, 2013 at 7:16 PM
Late Friday, interview requests were still pouring in for State Insurance Commissioner Mike Kreidler, who turned down President Obama’s rule change to allow insurers to keep discontinued individual health insurance plans.
The old plans were discontinued by insurers because they didn’t include a variety of benefits required by the Affordable Care Act, or in other ways didn’t meet the standards of the federal law.
Calls came in all day, and there were plenty of questions on the “Ask Mike” feature on the commissioner’s website. Many were from people unhappy with Kreidler’s stand, but nobody threw rocks or picketed the office, said his spokeswoman, Stephanie Marquis, who was half-expecting something unpleasant. “We’re so polarized as a nation. It’s a little bit unnerving.”
What made people mad were those notices from insurers that their plans had been scrapped, she said. Some of the letters simply told people their plans would be replaced with a more expensive one, but didn’t let them know that taking that plan wasn’t their only choice, and that they might find a less expensive option on the Washington Healthplanfinder exchange site.
“I wish we could have required the companies to send a particular letter,” Marquis said. But Kreidler’s office doesn’t have the authority to do that, she noted.
Most people who had been in the individual market for some time might well believe that the replacement offered was their only choice. “In the past, you had to take that,” she said. “But now you don’t.”
After Kreidler made his announcement Thursday morning, news organizations lined up for interviews, including The New York Times, The Washington Post, NPR, local TV, radio and newspaper outlets, and, late on Friday, Al Jazeera America, she said.
Kreidler’s two cents, Marquis said, went roughly like this: “He understands the president was put in a very hard place. And of the bills before Congress, the proposal Obama made was the least egregious. But even that couldn’t be done without tremendous upheaval in (Washington’s) market. And even if they say ‘you can keep your plan,’ that doesn’t mean your rates don’t go up — just like they have every other year.”
The one call Kreidler didn’t get? President Obama.
“I was hoping the president would call and thank him,” Marquis said. “Why not? He’s standing up for the law!”
October 22, 2013 at 12:56 PM
Seattle Children’s has filed an administrative action requesting that the state insurance office remove from the state exchange health insurance plans that don’t include the medical center in their networks.
The action, filed Tuesday, requests that the Office of the Insurance Commissioner remove the majority of plans from the Washington Health Benefit Exchange. Only two insurers, Group Health Cooperative and Community Health Plan of Washington, now include Children’s. The appeal seeks to remove Coordinated Care Corporation, Molina Healthcare of Washington, Premera Blue Cross, its subsdiary LifeWise, and BridgeSpan, a Regence subsidiary.
(Update, 2:30 p.m. Oct. 22: Seattle Children’s announced Tuesday afternoon that it has reached an agreement with Molina Healthcare of Washington and is now an in-network provider in the health plans Molina is offering through the state’s online insurance marketplace in 2014. Further details were not immediately available.)
The action comes less than a month after Children’s filed a lawsuit in King County Superior Court on the same issue. Children’s, in a news release, said it is concerned “that the plans that exclude us don’t provide adequate coverage for kids,” because many of its services are unique and not available anywhere else in the state.
Children’s is also asking the community to directly lobby Insurance Commissioner Mike Kreidler, who is holding hearings today on his request to broaden his control over insurer network issues.
September 11, 2013 at 9:33 PM
By now, you may have noticed that individual health insurance rates are considerably more more expensive if you’re a smoker. But just how much more? The state’s Office of the Insurance Commissioner says companies are allowed to set smokers’ health- insurance rates as much as 50 percent higher, if they could justify such hefty increases.
So far, the companies whose plans have been favorably reviewed by the Commish’s office (for inclusion in the online marketplace known as the Washington Health Benefit Exchange through its Healthplanfinder tool) haven’t gone that high. Group Health Cooperative came in the highest, with a 20 percent increase for smokers. BridgeSpan Health Company (an affiliate of the parent company of Regence BlueShield) levied a 15 percent increase, and Premera and its subsidiary, LifeWise Health Plan of Washington, had 7.5 percent increases.
August 29, 2013 at 7:24 PM
With about 16 percent of its residents uninsured, Washington state falls solidly in middie of the pack, with Texas having the highest percentage of residents without health insurance: more than 25 percent. Massachusetts, where a state health-insurance mandate has been in place for years, has the smallest percentage of uninsured residents at just under 5 percent.
But in one way, and not a good one, Washington nearly led the nation, a recent report revealed. From 2008 to 2011, the state’s increase in the number of residents without insurance was second-highest.
The latest numbers come from the U.S. Census Bureau’s recently released 2011 Small Area Health Insurance Estimates for counties and states.
Washington ranked ranked high in two other measures: the percentage of under-age-65 Hispanics without insurance, and the percentage of people under age 65 living at or below the poverty level without insurance.
Only Tennessee had a higher rate of growth in uninsured residents from 2008 to 2011. Some states stayed virtually the same, and some had decreases.
The Census Bureau’s report also looked at counties. In Washington, the county where the percentage of uninsured residents grew the most from 2008 to 2011 was San Juan with an increase of 4.3 percent. It was followed by Mason and Whatcom counties. King County had an increase of 2.5 percent.
August 26, 2013 at 11:48 AM
Welcome to HealthCare Checkup, a new blog intended to get us all better acquainted with the Affordable Care Act. We’ll keep you updated on health-insurance changes in Washington state and around the country that could affect you.
We’re pretty sure you’ve got questions about the federal health-care overhaul. Here, in just a few words — and a short animated video — is the quick overview you will need to wow your friends.
Basically, one major aim of the ACA is to pull everyone into one big insured pot by 2014. Most people are already there, because they’re insured through their workplace, through federal or state programs such as Medicare or Medicaid, military benefits or tribal health plans. But about 16 percent of the the people in Washington are uninsured, many because they can’t afford the premiums. That’s more than 1 million people in our state, so it’s likely that even if you’re already insured, you know someone who isn’t.
The law, which requires most people to have health insurance or pay a penalty, has two major ways to help people who don’t have insurance: One, Medicaid eligibility is being expanded, and federal dollars pumped in, so many more people at the very lowest income levels will qualify for the first time. Two, putting faith in the power of competition, the law creates an online marketplace (the “exchange”) to make it easier for people to compare insurance plans and, if their incomes are low enough, get a subsidy so they can afford to buy.
Now that you’ve slogged through the words, here’s the fun — such that it is: A quick video version to help cement your new-found knowledge.
About the blog
Trending with readers