State lawmakers get started on health reform

LEGISLATURE: Bills that set up insurance exchange carry broad support

March 14, 2011 

Washington lawmakers already are moving to put pieces of federal health reform into place well before the January 2014 drop-dead date for it to be implemented.

Almost a year after President Barack Obama signed the Patient Protection and Affordable Care Act into federal law, legislators of both parties are moving ahead to make sure health reform works here.

Rival bills that set up a state health insurance exchange – in which consumers will be able to buy policies – sailed through the House and the Senate this month. Some Republicans backed those and other related bills too.

Democratic Rep. Eileen Cody of Seattle said Gov. Chris Gregoire could move ahead administratively to set up the exchange, which the Legislature approved but did not fund a few years ago.

Cody and her Senate Democratic counterpart, Sen. Karen Keiser, are trying to work with minority Republicans. Cody remembers what happened in the early 1990s: The Democrats enacted reforms that were repealed when the GOP stormed to power.

“I don’t want to see what happened in 1995 with our health care reform happen again,” Cody said Friday.

The major bill creating a state-run insurance exchange, House Bill 1740, cleared the House on a 79-18 vote last week. House Republican Leader Richard DeBolt of Chehalis voted against it because he opposes the national reform, but he was outvoted by Democrats and his own party.

A similar proposal passed the Senate by a closer margin, 27-22. Just two Republicans – Sen. Randi Becker of Eatonville and Sen. Cheryl Pflug of Maple Valley – voted for SB 5445, which Pflug co-sponsored.

Becker said she wants the state to have an exchange in place because Republican efforts to kill federal reform in Congress or in the federal courts might fail. If that happens, the state will have its own exchange or the federal government will set one up instead, Becker said.

Keiser and Pflug’s bill begins setting up the insurance exchange in September, while Cody’s approach waits until July 2012, after the next legislative session.

Becker said she doesn’t support federal reform and prefers the slower approach in the House. She said the wait might allow for more discussion and more points of view.

In a sign Republicans and Democrats see eye to eye more easily in Olympia than in Congress, Senate Republican Leader Mike Hewitt of Walla Walla said he agreed with the argument by Pflug that some form of health insurance exchange is inevitable. He explained his vote as a protest against “Obamacare” and its mandate to buy insurance.

Cody and Keiser are battling Republicans and even Democrats on other fronts as they move to line up the state for 2014. Both want to save the state’s Basic Health Plan and the Disability Lifeline, both of which could lose all funding after June 30 because of the looming $3.6 billion to $5.5 billion budget shortfall.

Cody and Keiser consider both programs part of an essential bridge to help low-income workers and others stay insured until they become eligible for more help in 2014.

The Basic Health Plan provides a subsidized health insurance policy for about 35,000 people, but it is less than one-third its former size because of budget cuts. The Disability Lifeline provides health care and a small stipend to thousands of unemployed people who do not qualify for other aid and in many cases are in line for federal disability benefits.

Both received a waiver under federal reforms that qualify them for federal payment for half the cost.

“I and others will do everything we can to continue to sustain (BHP and the Lifeline). To lose that and have people uninsured for 30 months until health care reform takes place would be horrible,” Cody said.

Her exchange bill, House Bill 1740, goes to a hearing in Keiser’s Senate Health and Long-Term Care Committee at 1:30 p.m. today along with other reform-related bills.

One other, HB 1560, would make changes to the state Health Insurance Partnership, which provides subsidies to help small businesses to provide health insurance to low-paid workers. There was a strong Republican vote against it in the House, and business groups also objected to it.

Also in play is a bipartisan bill, House Concurrent Resolution HJR 4404, sponsored by Republican Rep. Joe Schmick of Colfax. It extends the work of a joint select legislative committee created a year ago to study the exchange and other federal reform issues.

That study group now will look at cost containment in medical care and other issues, Becker said.

Brad Shannon: 360-753-1688

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