State Insurance Commissioner Mike Kreidler and area lawmakers have been communicating with individual health insurance providers about offering coverage to the more than 2,000 residents in Grays Harbor County that could find themselves without any options come January 2018.
Kreidler announced last week that no insurance providers have signed up to offer individual health insurance in two counties — Grays Harbor and Klickitat. The situation wouldn’t affect people who are part of group insurance plans such as those offered through an employer, or people on Medicare supplements.
Some were quick to blame either the existing Obamacare system or uncertainty created by President Trump and Republicans in Congress. But at least one local physician pointed the county’s consistently poor health rankings as the reason insurance companies consider Grays Harbor a poor risk.
Whatever the cause, if lawmakers are unable to persuade insurance carriers to return to the individual health care market by early fall, those 2,000-plus Grays Harbor County residents that currently rely on subsidized health care plans would have only one option — the state’s high risk pool. But it’s not subject to subsidies and the high premiums would make it very difficult for most current health care plan subscribers to afford.
Kreidler has been in meetings for more than a week, attempting to find a way to woo insurers back to Grays Harbor County.
“He had a meeting with most of the insurers (June 9), and a couple of them on Monday,” said Stephanie Marquis, spokesperson for the Office of the Insurance Commissioner. “There’s another meeting (Friday) and a call on Monday. We are hoping to have some news Monday.”
Monday is a big day in the effort to bring individual health insurance back to Grays Harbor County.
“Monday morning is also when we release the proposed rate changes for insurers, getting all those finalized,” said Marquis. “And there is a work session about individual health insurance in the House Health Care and Wellness Committee at 1 p.m., and I think most of the insurers will be there.”
Also, a letter was sent to all individual health insurance providers soon after it was discovered none would be offering plans in Grays Harbor County earlier this month. “There was a letter sent to all carriers asking about their concerns with insuring in the county,” said Marquis. The deadline for carriers to send their responses was Friday, and the Insurance Commissioner and staff are putting together their concerns for Monday’s workshop.
Kreidler’s role
The Insurance Commissioner has some power to control how insurers operate within the state, but it stops short at having the authority to force them to supply coverage to specific counties.
“But there are requirements we have to oversee one of the primary issues, which is network access,” said Marquis. “We have standards for what type of providers they have in their provider network, so we may have some flexibility there.”
Provider networks can be complicated, especially in rural counties. For instance, in Klickitat County — the other county that finds itself currently with no individual health insurance providers for 2018 — there is little or no maternity health services. Insurers there, said Marquis, had to make a deal with Oregon insurers and providers to accept Washington plans. The end of that program was a factor in insurers’ decisions to pull out of the individual health insurance market in Klickitat County.
Senate legislation introduced Friday
Senators Maralyn Chase (D-Edmonds) and Bob Hasegawa (D-Beacon Hill) introduced Senate Bill 5957 Friday, which would require companies offering individual health care plans in the state to offer that coverage in all counties. In part it reads, “It is the intent of the Legislature to establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state.” It has been referred to the Senate Health Care Committee but a hearing date has not been set.
Walsh weighs House action
Rep. Jim Walsh (R-Aberdeen) introduced legislation Friday that would encourage insurers to return to Grays Harbor County by giving them a choice in the types of plans they could offer.
“When a county gets down to zero or even one provider, we would allow insurers to offer only Bronze and Catastrophic plans,” he said. This would eliminate the Platinum and Gold level plans, where the premiums are higher but the plan pays 80 to 90 percent of your medical costs. The Bronze and Catastrophic premiums are lower but the coverage amount for treatment drops significantly; these plans are the least costly for insurance carriers.
Walsh said the Senate bill “is not a good solution” to the problem. “In my opinion we need to loosen up the underwriting requirements, not add more,” which he said the Senate bill would do.
The bill says, in part, that in any county where one or fewer insurers sign to provide individual health care, the commissioner must extend the filing deadline by at least 60 days for plans to be offered in that county. It goes on to say it intends to reduce state health insurance mandates in counties with one or fewer health plans offered in the individual market in order to incentivize insurers to re-enter the marketplace and revitalize competition and consumer choice. Walsh said major factors for the drop in insurance carriers in the county include increasing premiums, decreasing carrier participation, and what he calls excessive health insurance mandates upon carriers that give them little incentive to stay.
“What your readers need to know is there is still time to fix this before 2018,” said Walsh.
Summit Pacific Medical Center reacts
Summit Pacific Medical Center in Elma provided its reaction to the insurance coverage crisis in a news release Friday.
“Although we don’t anticipate that this reduction in healthcare coverage will have a significant impact on operations at Summit Pacific at this time, we will continue to monitor the situation,” said Josh Martin, CEO of Summit Pacific Medical Center. “We understand that this development will have a substantial effect on many individuals in our community. We will be looking at ways to offer immediate assistance for those impacted and will be working behind the scenes to address the bigger issues at play by discussing the importance of affordable health insurance options for our community to key government heads, various state organizations and insurance companies.”
According to Martin, Summit Pacific Medical Center will continue to provide healthcare to its patients regardless of their ability or inability to pay.
“We have several programs in place to assist in making healthcare services affordable to those in our community, including our Community Care Financial Assistance program and our Property Tax Credit for those living within our hospital district boundaries,” he said.
