State put itself ahead of the health care curve

January 27, 2013 

Washington state lawmakers have placed two bets on the future of Obamacare. One has already paid off handsomely. The other doesn’t look as promising.

First, while most states balked at preparing to implement the Affordable Care Act – including those who hoped the U.S. Supreme Court would rule it unconstitutional – this state’s Legislature plunged ahead enthusiastically, despite the legal limbo.

Washington lawmakers passed laws in 2011 and 2012 establishing our health benefit exchange, setting the rules, writing the requirements for health plans to qualify for inclusion and generally paving the way for the state to receive millions of start-up dollars from federal grants.

We might have looked silly if the high court had struck down Obamacare. Instead, Washington is far ahead of most other states in implementing the president’s federal health care law.

There’s little worry here, as there is in other states, about opening the health insurance marketplaces by the October 2013 deadline, and providing coverage starting Jan. 1, 2014.

Credit our Legislature and Insurance Commissioner Mike Kriedler’s office with putting Washington ahead of the curve. As a result, a projected 79 percent of Thurston County’s 55,700 uninsured people can start receiving health benefits next January under Obamacare.

Kriedler’s office is concerned, though, about the huge wave of people entering the insurance market statewide, perhaps as many as 800,000.

Second, the previously Democratically controlled Legislature apparently gave up oversight of the Health Benefit Exchange, probably hedging its bet on who might become Washington’s next governor and which party would win control of the House and Senate.

The Health Benefit Exchange was formed as a public-private partnership, separate and distinct from the state. It is overseen by an 11-member board appointed by the governor from names put forward by each legislative caucus.

That raises questions about who holds the exchange accountable. It appears that although the board must comply with open public meeting and public disclosure laws, it remains accountable only to itself.

The Legislature controls the health exchange’s budget, of course, and perhaps that’s enough. Nobody wants the Legislature to micro-manage, or inject politics into such a complicated endeavor, but citizens would feel better knowing someone is overseeing a board charged with managing such a critical piece of health care reform.

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