Because Obamacare’s individual mandate is so weak, and because the Obama administration created various loopholes to juice enrollment numbers, people who sign up for exchange-based coverage have had the ability to come in and out of the system whenever they need someone to pay for their health care. UnitedHealth Group, America’s largest health insurer, announced that “over 20 percent of our enrollment base were folks that had joined us after enrollment,” increasing to 30 percent, and that these late enrollees were consuming 20 percent more health care than usual enrollees.
On Tuesday Governor Inslee, a Democrat, vetoed several sections of Senate Bill 6656, including a portion that would have allowed psychiatric nurses with advanced degrees to fill vacant psychiatrist positions at the hospital. State Sen. Andy Hill, the Republican sponsor of the bill, said Inslee had nixed the measure’s most important reforms.
This change will likely have little to no effect on the Exchange’s individual market where UHC had less than 2% of the enrollment. However, this will affect the Exchange’s small business marketplace With the loss of UHC, the Exchange does not anticipate continuing with a statewide SHOP in 2017. Rather, SHOP will “likely be limited to two counties in SW WA served by Kaiser.”
The innovations that some states are implementing to reduce costs while maintaining or improving quality can and should be replicated by other states. This report lays out a comprehensive summary of options that states can choose from to improve the quality and sustainability of their health care systems.