Variety of state exchange offerings will continue in 2018
By Marcy Stamper
Against a backdrop of uncertainty on the federal level, insurance companies in Washington have reduced their health insurance offerings, but three insurance companies still plan to sell policies in Okanogan County through the state exchange in 2018.
That puts Okanogan County residents who buy their insurance through the exchange – most of whom receive subsidies to reduce out-of-pocket costs – in a better position than their counterparts in Klickitat and Grays Harbor counties. In those counties, currently no insurers plan to sell policies next year, according to Washington Insurance Commissioner Mike Kreidler.
In Okanogan County, Asuris Northwest Health, Lifewise Health Plan of Washington, and Premera Blue Cross have submitted plans to sell policies through the exchange in 2018. Asuris will sell five plans – two bronze, two silver, and one gold; Lifewise will sell four – one bronze, two silver, and one gold; and Premera will offer seven – three bronze, two silver, and two gold.
The bronze, silver and gold categories are set by the Affordable Care Act (ACA, also called Obamacare) and describe what portion of medical costs the patient pays and what portion the plan pays. People who qualify based on their income can obtain subsidies through the exchange.
Almost 46 percent of Okanogan County residents bought their health insurance through the state exchange in 2016. The majority of those 6,284 people (81 percent) qualified for Medicaid coverage through its expansion under the ACA, according to the insurance commissioner.
The other 1,209 bought other policies on the exchange – and received an average of $309 a month in cost-sharing and subsidies. One-fifth of Okanogan County residents under 65 are covered by Medicaid or ACA policies.
Not everyone who buys a policy through the exchange qualifies for a subsidy, but some people go through the exchange anyway because it provides tools to compare policy features, said Stephanie Marquis, a spokesperson for the Office of the Insurance Commissioner. Almost 700 people in Okanogan County buy individual policies directly from insurance companies.
Molina Healthcare of Washington sold insurance in Okanogan County through the exchange this year, but did not file to sell policies again next year. Two other insurers sell individual policies directly to consumers outside the exchange, but those are not eligible for subsidies, said Marquis.
Uncertainty about ACA, HCCA
Kreidler attributed the lower participation by insurance companies to uncertainty about health coverage because of an effort in Congress, called the Health Care Choice Act of 2017, to follow through on a promise to repeal Obamacare. The Health Care Choice Act would significantly change the ACA.
According to the insurance commissioner’s comparison of the ACA and the Health Care Choice Act, the proposed legislation would eliminate subsidies and cost-sharing. It would allow insurers to charge higher premiums based on age, health status or preexisting conditions.
Under the proposed legislation, insurance companies would not be required to cover 12 essential benefits. The proposal would change preventive health coverage for women, either eliminating it entirely or eliminating contraceptive coverage, according to the insurance commissioner. It would change minimum standards for drug coverage and treatment for substance-abuse disorder.
Some individuals, particularly those who are young and healthy, have urged Congress to lift the mandate that they pay for coverage or benefits they deem unnecessary and costly. The proposed changes to Obamacare would also eliminate the requirement that everyone have insurance, along with the penalties for not having it.
“For months, we’ve worked closely with our health insurers and other stakeholders in a concerted effort to try to explain to the Trump administration and Congressional leaders what the impact could be to our market and most importantly, to our consumers, if this level of uncertainty and volatility continued. Today, our predictions came true,” said Kreidler last week in a statement about the insurance company filings.
Under current Washington law, if no health insurer is available in a particular county, the only coverage option is through the state’s high-risk pool, but that pool does not provide subsidies, according to the insurance commissioner.
“I will be reaching out to our health insurers this week to strongly encourage them to reconsider their participation in the two counties that have no options for 2018,” said Kreidler.
These filings by insurance companies are the first step in the filing period, which had a deadline of June 7. Proposed rates and details will be available later in June, but Kreidler will not issue any decisions on the plans and premiums until early fall. Rates and coverage areas may change during the review, according to his office.
