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Health exchange rules good for small business, consumers


The Association of Washington Business (AWB), our state’s Chamber of Commerce, is fighting to eliminate industry regulations!

Not exactly a “man bites dog” newsflash, huh? After all, that’s what AWB is paid to do: oppose government efforts to regulate private industry. But if there was ever a private-sector industry in need of regulation, it is our failed health insurance system.

Small businesses, which have paid on average 18% more for coverage than large employers, know this first hand.

Last year, our state hit the grim milestone of having 1 million Washingtonians who lack health coverage. That’s one in every seven of us who no longer have affordable access to meeting our medical needs because of skyrocketing costs and the recession-related shredding of health care safety net programs designed to help the poor afford coverage.

With the passage of the Affordable Care Act two years ago, our government is finally tackling this issue head on. And so far, the results are positive. State Insurance Commissioner Mike Kreidler reported this week that ACA benefits to Washington health care consumers include:

  • More than 2.4 million people who no longer face lifetime caps on their health benefits.
  • More than 52,000 young adults up to age 26 who have stayed on their parents’ health plans.
  • More than 1.2 million people who now have coverage for preventive care with no co-pays or deductibles.
  • More than 60,000 people in Medicare who have saved hundreds of dollars on their prescription drugs.

Small businesses are now receiving health care tax credits worth up to 35% of the cost of their health plans.

But one of this law’s biggest components, designed to move the nation toward universal coverage, will be implemented in 2014: the establishment of state-based health benefit exchanges. These will be a menu of private and federally subsidized health plans from which small businesses and individual consumers can choose starting that year.

This year, the State Legislature approved HB 2319, sponsored by Rep. Eileen Cody (D-Seattle) and Sen. Karen Keiser (D-Kent), which sets some minimum standards for health plans and coverage offered starting in 2014. Without defined standards, bare-bones cut-rate coverage will continue to be par for the course on the open private insurance market — which will operate outside the realm of the exchange — and would cream the healthiest customers from the market, prohibitively driving up the costs of the plans within the Exchange.

Enter our friends at the AWB, who are trying to convince Gov. Chris Gregoire to veto some key provisions in the law on behalf of some of the biggest private insurers in the state. In his latest column, AWB President Don Brunell brandishes ideological anti-government catchphrases and fear-mongering to rail against HB 2319 and the “state bureaucrats in Olympia” whose “extreme intrusions into the marketplace will convince some of the few remaining insurers that it’s time to leave the state.”

The “bureaucrats” he refers to are also known as Washington State Senators and Representatives. You know, these are the people from our communities who we elected to decide things like whether there should be rules and minimum standards for health insurance sold in our state.

Our elected representatives heard expert testimony on this issue from our state Insurance Commissioner, from small business owners, from large and small insurance companies, from advocates for health care consumers, and even a handful of the one million people in this state who lack health coverage. They also heard compelling stories from family members of some of the people who couldn’t testify in Olympia — because they couldn’t afford medical treatment and they are now dead.

In the end, nobody got everything they wanted. But a delicate balance was struck in the final compromise, enough so that the vast majority of stakeholders — and, obviously, majorities in both houses of the Legislature — supported HB 2319 as approved. This included representatives of the medical community and  health care advocates (American Cancer Society, American Lung Association, etc.); union organizations (Washington State Labor Council, Washington State Nurses Association, SEIU Locals, etc.); consumer advocates (Washington Community Action Network, Children’s Alliance, etc.); and yes, business lobbying groups and private health insurance providers who support health reform and improving access to care (Main Street Alliance of Washington, Group Health Cooperative, Community Health Plan, etc.)

The ones who didn’t support the final compromise were a few of the biggest insurers — namely Premera and Regence — which want to selectively offer bare-bones lower-value coverage to the “lowest risk” customers and don’t want the government telling them they can’t.

But in this case, it is in the best public interest for our government to do just that. Without a level playing field among insurers that spreads the risk, insurers will “cherry-pick” healthy patients and prohibitively raise the costs of coverage for everyone else.

For big insurance and their allies at the AWB, it seems like their only solution to make coverage affordable for small businesses and consumers is to strip down the quality of coverage options.  Thankfully, elected leaders saw things differently.  Just because you work at a locally owned and operated small business doesn’t mean you should be forced to settle for substandard health care.

Having failed to defeat HB 2319, AWB is leading a full-court press of bombastic emails and letters to Gov. Gregoire urging her to veto provisions in the law that discourage this cherry-picking and level the playing field for all insurance companies – big and small.

Let’s hope they don’t succeed, for the sake of small businesses and consumers across the state.

Don Orange is the owner of Hoesly ECO Auto & Tire in Vancouver, and the chair of the Main Street Alliance of Washington, a coalition of more than 2,000 small business owners. This column originally appeared at the MSA’s website, and is crossposted here with the author’s permission.

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