Monday, August 5, 2013
OLYMPIA - Washington state residents have a clearer picture of what Obamacare will mean for them after insurance commissioner Mike Kreidler announced last Thursday his approval of 31 insurance plans for the state's new insurance exchange. Final say on the plans is dependent on review and approval by the Washington Health Benefit Exchange Board, which is expected to reach a decision at its Aug. 21 meeting. Called the Washington Healthplanfinder, the plans will be available pending board approval starting this coming October. Of the 31 plans Kriedler approved, only eight will be available statewide. Those are all provided by Lifewise. The company's proposed monthly premiums for a 40-year-old non-smoker in Yakima County range from $237 for a bronze plan with a $6,350 annual deductible covering 60 percent of health care costs to $357 for a gold plan with a $1,000 deductible covering 80 percent of costs. Smokers can add about $20 to those monthly premiums. The monthly premium costs in the exchange mentioned above do not reflect subsidies that will kick in for many rate payers, says Stephanie Marquis, a spokesperson for Kreidler's office. Marquis says under the new federal guidelines, premiums cannot be more than 9.5 percent of a person's salary. She says subsidies should be available for customers making less than $45,000 per year. "We're now one step closer to giving Washington consumers access to affordable health insurance," Kreidler said in last week's announcements. "Many of the companies will look the same, but they're going to sell all new plans with much better benefits." In addition to Lifewise, Yakima County residents will also have access to insurance exchange plans offered by Group Health Coop and Premera, which will offer exchange plans to all Washington counties except Clark. Of the 31 plans Kriedler approved, only about a fourth - eight - cover customers at the gold level or 80 percent of medical costs. Plans outside the exchange were also approved for Group Health, Lifewise and Premera. Marquis says those rates will not be eligible for subsidies. All of the approved plans include the 10 essential health benefits such as prescription drug coverage and maternity coverage. Also, annual out-of-pocket costs including deductibles and copays are capped at $6,350 for an individual and $12,700 for a family. As for plans inside the exchange for small employers - those with 50 or fewer employees - the only option is Kaiser. Those plans, though, will only be available in Clark and Cowlitz counties. That means small employers in Yakima County, if they don't offer plans already, will need to acquire employee health plans outside of the exchange and its subsidies. "We can't force an insurance company to sell a product they don't want to sell," Marquis told the Daily Sun News this morning about the lack of small employer plans. "The issue is, this is a complete overhaul of the market. Because the timeline is so tight they (insurance companies) focused on the individual market." She says employers with more than 50 employees have been given an extra year to comply with the insurance mandate. In his comments last week, Kriedler noted five other insurance companies submitted plans for the health exchange and were denied. Those not approved include Moda Health Plan, Inc., Kaiser Foundation Health Plan of the Northwest, Community Health Plan of Washington, Coordinated Care Company and Molina Healthcare of Washington, Inc. "Unfortunately not all of the insurers who applied were approved," said Kreidler. "It's our duty to make sure that if you buy a health plan, you can actually see the doctor or hospital that provides the service you need. This was a challenge for some of the insurers new to the commercial market. We're committed to working with these companies to help them get ready for 2015." He adds the state's health exchange is a work in progress in meeting the October deadline established by federal guidelines. "Getting to this point has been challenging, but the end result will be worth it," Kriedler says. "For too long, people have struggled to find affordable coverage. If they have insurance, they've continued to pay more, yet seen their benefits dwindle. The new plans for sale starting this October provide meaningful coverage and will give people peace of mind and financial security." Though plans will be available in October, they will actually take effect on Jan. 1, 2014.