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U.S. NEWS Monday 13 May 2019

Washington to offer

first ‘public option’

insurance in U.S.

By TOM JAMES work by a state legislator
The Associated Press and later officially request-
SEATTLE (AP) — Washington ed the public option bill.
is set to become the first Its sponsor, Seattle Sen.
state to enter the private David Frockt, a Democrat,
health insurance market said the hybrid system was
with a universally available a compromise. In this April 29, 2019, file photo, Gov. Jay Inslee, surrounded by
public option. “What’s important about Democratic lawmakers from the Senate and House, talks to the
A set of tiered public plans this plan is that the govern- media following the Washington Legislature adjourning its 105-
will cover standard services ment is coming in and tak- day legislative session in Olympia, Wash.
and are expected to be up ing a more aggressive role Associated Press
to 10% cheaper than com- in regulating the cost driv- But even at the higher rate, brid management model.
parable private insurance, ers of health care,” Frockt the plan risks leaving cover- Despite its name, the public
thanks in part to savings said. age gaps in the least-pop- option won’t be provided
from a cap on rates paid to The core proposition ulated counties, said Dem- by the state itself, and state
providers. But unlike exist- of Washington’s plan, ocratic Rep. Eileen Cody, employees won’t deal di-
ing government-managed dubbed Cascade Care, is an early architect of the rectly with patients.
plans, Washington’s public that it will save consumers plan who chairs the House Instead, the measure di-
plans are set to be avail- money by capping pay- Health Care and Wellness rects state health care
able to all residents regard- ments to doctors, hospitals committee. authorities to hire one or
less of income by 2021. and other health care pro- The state has already had more private insurance
The Legislature approved viders. problems guaranteeing companies: The state will
the plan last month, and The cost cap is central to private coverage in those determine the broad out-
Gov. Jay Inslee is sched- the program’s long-term areas. Two counties were lines of the public plans,
uled to sign it into law Mon- survival: Set it too high, and recently at risk of having no but private companies will
day. there will be no savings to insurers offering individual handle day-to-day admin-
The move thrusts Wash- pass along. Set it too low, plans, and others have only istration, including enrolling
ington into the national and the state runs the risk a single hospital or hospital patients and paying out
debate over the govern- of providers declining the network, allowing providers claims.
ment’s role in health care, plan, leaving it to whither to drive up costs. “It’s an attempt to keep
with a hybrid model that as consumers seek alter- The result has been rural the insurance compa-
puts the state to the left of natives that provide more areas bucking the state’s nies in the game,” said
market-only approaches choice, said Jennifer Tol- broader trend of moderate Aaron Katz, a University of
but stops short of a com- bert, director of the Kaiser cost increases: A quarter of Washington professor who
pletely public system. Foundation’s state health Washington counties, most- teaches health policy and
Instead, the state will dic- care analysis program. ly rural, have seen triple- has studied U.S. health
tate the terms of the public The question is especially digit increases in the cost of care markets.
option plans but hire pri- critical in Washington’s ru- premiums for a benchmark Like earlier decisions to
vate insurance companies ral counties, many of which bronze-level plan in the last have private companies
to administer them, saving were already hit hardest by year alone, with some rising administer parts of the
the state from having to health care cost increases. by as much as three times Medicare and Medicaid
create a new bureaucracy To attract providers, Wash- the increase seen in King systems in some states,
— and guaranteeing a role ington lawmakers chose County, home of Seattle, Washington’s hybrid model
for the insurance industry in a relatively high figure to according to data from tries to preserve some com-
managing the new public start: The plan caps pay- the Kaiser Foundation. petition while fixing prob-
option. outs at 160 percent of fed- Another unique aspect of lems like stability and cov-
Lawmakers in at least eight eral Medicare rates. Washington’s plan is its hy- erage gaps, Kaatz said.q
other states including Col- That’s more than other
orado and New Mexico states have proposed. In
have proposed their own New Mexico, lawmakers
public option measures. But considered using Medic-
so far none have passed aid rates, among the low-
legislation implementing a est paid to doctors and
public option. hospitals by any insurance
Backers acknowledge the plan. Lobbying firm Manatt
rate caps at the heart of estimated that could have
the plan risk creating cov- translated into cost savings
erage gaps in rural areas. for consumers of more than
But they hope to persuade 20% compared with similar
doctors to accept lower private plans on the indi-
rates by bringing the state’s vidual market.
purchasing power to bear. By comparison, Washing-
The savings would be used ton’s higher pay rate for
to sell the plans at a com- doctors is estimated to
petitive price. save participants only 5 to
Inslee, who is also running 10%, according to Jason
for president, embraced McGill, Inslee’s senior poli-
the idea based on early cy adviser on health.