When
Washington Gov. Jay Inslee (D) recently signed a bill setting up the nation's
first public option health insurance program, he touted it as a model for the
rest of the U.S.
Under
the new law, the Washington Health Benefit Exchange — the state-based Affordable
Care Act marketplace slated to sell the new standardized plans alongside
non-standardized plans by Jan. 1, 2021 — must develop a plan to implement and
fund premium subsidies for individuals who have modified adjusted gross incomes
of less than 500% of the federal poverty level and who are buying individual
market coverage on the exchange.
While it
is too soon to say whether Washington state's program will be a game changer,
it is a strategy that other states are watching closely, says Joel Ario, a
managing director at Manatt Health who previously served as director of HHS's
Office of Health Insurance Exchanges. He notes that the bill, while leaving out
many details, specifies the new standardized plans will cap total provider and
facility reimbursement rates at 160% of Medicare. He adds there is "wiggle
room on the rating issue, which is probably the most important issue,"
allowing the state to take some as-yet-unspecified steps if public option plans
cannot build adequate provider networks under the rate structure.
Yet the
head of the Association of Washington Healthcare Plans (AWHP) says its members
remain cautious pending further details from the state. They also worry that
the state's ambitious timetable won't allow much time for plans to digest
information, figure out provider networks and pricing and file to participate
in the new program, called Cascade Care.
From Health Plan Weekly
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