Strong words were heard on September 19th at the Health Benefit Exchange Board meeting. The Governor is trying to ensure Washington State is one of the first states in the country to build a health insurance exchange. But it is the federal government that is behind in the publishing of needed guidelines. This in turn with the implementation deadlines has made it impossible for the state HBE staff to prepare the legal and design analysis required for many of the Board decisions. The federal Basic Health Plan option is an example of one discussion that has already had to be put on hold.
All of this came to a head on Wednesday, with the debate over how to administer the pediatric dental essential benefit. Without the legal or federal guidance required to understand the options, the State Insurance Commissioner’s Office was left to drive the debate and the Board was left to make a gut level decision. The State will go beyond federal requirements and mandate coverage in all health plans, further increasing costs but ensuring coverage for all kids.
Board member Melanie Curtice expressed a shared conclusion, “We need a process to get the advice we need.”
The Board made was able to make another decision with less controversy regarding the information to eventually be included in the Consumer Rating System.
The Board and Operations Committee also discussed sustainability, how the HBE will fund itself after the first year of federally funded operation in 2014. That conversation will continue at the next Board meeting on October 18.
The exchange is the state centerpiece of federal health care reform where small businesses and individuals will be able to buy insurance and determine if they qualify for subsidies. State residents will also still be able to buy insurance outside the HBE.