Support The Wire

Governor Signs Health Exchange Bill – Just in Time for Health Reform’s Final Test Before Supreme Court

Gregoire signs this year's health exchange bill in a ceremony at Group Health's Olympia hospital. The ceremony was timed to coincide with the second anniversary of the federal Affordable Care Act -- when it was done, lawmakers passed out birthday cake.

OLYMPIA, March 26.—Just as federal health reform faces its final test today in the other Washington, officials in this one are gearing up to put it into effect. Gov. Christine Gregoire put her signature Friday on a bill that state officials say will give Washington one of the strongest health exchanges in the country when the federal program takes full effect in 2014.

The exchange, sort of an online supermarket for health insurance, is the focal point for health reform at the state level. The idea is that consumers will be able to choose between a standard set of health policies offered by private insurers. Those earning between 138 percent and 400 percent of the federal poverty level will be eligible for subsidies or tax credits.

Though lawmakers last year authorized state officials to create their own health exchange, rather than leaving the job to the feds, this year’s measure triggered furious debate because it goes beyond the minimum standards imposed by the federal Affordable Care Act. House Bill 2319 imposes “market rules” that are designed to restrict competition against the policies offered on the exchange. Private insurance companies will still be allowed to offer policies on the “open market,” albeit without the advantage of subsidies or tax credits, but state regulators fear that unfettered competition would allow insurers to undercut the premiums offered on the exchange.

The measure was opposed by business organizations and private insurance companies primarily serving the consumer market, and Republicans argued that it was foolish for the state to go beyond federally mandated minimums when success of the national program is in doubt. But the measure was favored by Democrats and health reform advocates, and it won narrow passage in the House and Senate on largely party-line votes.

Meanwhile, the U.S. Supreme Court hears argument today in a suit filed by Republican governors and attorneys general that seeks to overturn another key element of federal health reform – the “individual mandate” that requires Americans to obtain health coverage. The court also could overturn health care reform itself.

Gregoire and state Sen. Karen Keiser, D-Kent, chairwoman of the Senate Health and Long-Term Care Committee, said Friday the state health exchange will remain in place even if the federal act is overturned.


Your support matters.

Public service journalism is important today as ever. If you get something from our coverage, please consider making a donation to support our work. Thanks for reading our stuff.