Under the Affordable Care Act, the new federal health care reform law, states may include a federal version of the basic health plan at the state level. The concept was pioneered in Washington State and provided subsidized health insurance to low income families. State legislation passed this year sought to continue efforts to implement the federal version in Washington State in 2014 when the state health insurance exchange is implemented.
On Tuesday, Governor Chris Gregoire, in consultation with the legislative committee chairs, placed the project on hold, eliminating any chance for 2014. As explained in an email from her health care policy lead, Jonathan Seib:
“Members of the legislative health care committees –
As you know, for some time the state has been working towards the implementation of the Basic Health Plan Option (BHPO) under the federal Affordable Care Act. Beginning January 1, 2014, it would provide coverage for individuals between 133% – 200% of the federal poverty level in lieu of their enrollment in subsidized commercial coverage in the Health Benefit Exchange.
In order to implement the BHPO, we need sufficient guidance from the federal Department of Health and Human Services (HHS) to assure that what we put in place will eventually meet their approval. So while we’ve been doing what we can on design and development, we’ve also been pushing HHS to provide that guidance. In June, we submitted a detailed proposal for their review, offering what we saw as a more viable approach than a time-consuming federal rules development process to get the feedback we needed.
HHS has acknowledged our interest and efforts, but despite follow-up by us and others, has not responded with any guidance. Neither have they indicated when they might do so. Meanwhile, the Exchange has reached a point in its development where the major features of the BHPO need to be locked-in. And rather than lock-in features with no idea whether they will ever meet HHS approval, it made sense instead to suspend our work on the BHPO.
This decision was made in consultation with Senator Keiser and Rep. Cody. It means that we will likely not be able to offer the BHPO in this state on January 1, 2014. While very disappointing, the decision frees up staff resources to commit to other pressing needs, particularly for the Exchange. It also brings some certainty to the required work being done by the Office of the Insurance Commissioner regarding reinsurance – which was struggling with what to assume regarding the BHPO.
I will let you know if anything on this changes. In the meantime if you have any questions, please be in touch.
Jonathan Seib, Executive Policy Advisor”