The recent decision by state Insurance Commissioner Mike Kreidler to reject some insurers’ applications to list policies with the Washington Healthplanfinder exchange is drawing fire. Kreidler rejected several insurers’ applications last week because the offerings did not meet legal requirements.
The Washington Health benefit Exchange is scheduled to take up a review on Aug. 21 of 31 plans from four insurers that were approved by Kreidler’s team for offering when the Healthplanfinder exchange starts enrolling consumers on Oct. 1.
Republican Sen. Linda Evans Parlette of Wenatchee said Thursday the options are too few and that insurers like Molina, which she said have been approved in eight states, were rejected here.
In a statement posted on Parlette’s legislative site, the Senate Republican Caucus chair said:
“The stated goal of insurance exchanges – as we’ve repeatedly been told – is to increase choice and competition for health insurance … Dismissing the majority of the prospective insurers out of hand before the Health Benefit Exchange Board even has an opportunity to consider them seems to be a step in the wrong direction. After all, don’t we want as many options as possible for people who are purchasing health insurance?”
Parlette went on to say it means that “companies that have dominated Washington’s insurance market in recent years will likely operate without new competition in the exchange. She said the four companies include Premera, Lifewise, Bridgespan and Group Health Cooperative and that, because Lifewise is a subsidiary of Premera, “there are really only three different companies offering plans.’’
The rest of her criticism is here.
Commissioner Kreidler’s office has said that bids received by his office from insurers are better - as in lower priced - than feared. Kreidler, a Democrat who supported ObamaCare, noted Thursday that despite the rejection of some plans for the exchange, other insurers' plans will be available on the open market - outside the exchanges - if they meet state standards.
In a formal statement meant to rebut Parlette, Kreidler said:
I’m very pleased with the 31 plans we approved for the Exchange – they’re quality plans with good benefits. More people will be able to get covered than ever before and the plans are higher quality and offer better value. Many people will qualify for subsidies to help with the costs.
Unfortunately, not all of the insurers who applied were approved. Some of the plans were new to the commercial market and it’s a big challenge to meet the criteria to enter that market.
For more than a year, we went to great lengths to help these companies succeed. We held dozens of meetings and discussions with their staff and CEOs. We held 14 webinars, starting as early as June 2012, to help them get through this process. Our staff worked until midnight on the final night to give the carriers every possible minute, but in some cases, they didn’t succeed.
Examples of specific problems include:
Molina – Didn’t allow adequate access to certain providers such as HIV/AIDs specialists and proctologists. It also had no approved retail pharmacy.
Coordinated Care Company – Had no pediatric hospital in its network and no approved vision network.
Community Health Plan of Washington –Couldn’t adjust its benefits to meet the new cost-sharing requirements. It also required people – even those living in an urban area – to drive more than 47 miles to see a cardiologist and 123 miles to see a gastroenterologist.
Kaiser – Had several Health Savings Account (HSA) plans that didn’t meet the federal requirements of an HSA.
Moda – Wanted to charge the same rates for plans with different benefits.
Kreidler went on to say he supports “competition in the market” but has responsibility to ensure plans meet state and federal legal requirements.
“It’s also critical that if consumers buy a plan, they’re actually able to use the benefits they’re promised,” he stated. “While I wish all of the companies who applied had succeeded, I had to hold everyone to the same standards. I remain optimistic about next year, when I fully expect more insurers to apply and more to succeed.”