OLYMPIA, Nov. 22.—Washington might have one of the best track records in the country as Obamacare gets under way, but the national huzzahs for a website that actually functions and the hoopla about big signups are overblown, lawmakers said Thursday. It’s a case where the numbers don’t tell the story.
What does, lawmakers say, are the phone calls that are flooding their offices as Washington residents express shock and horror about the insurance premiums they will have to pay when the program kicks in on Jan. 1. Washington has enrolled nearly 100,000 people in new health coverage, and amid the dismal Obamacare rollout the stat has been touted as a nationwide success story — a rare demonstration of competence in the upper left-hand corner of the country. But here’s what the number doesn’t tell you: Some 90 percent of those enrollments have been for free coverage via Medicaid. As far as the rest of the public is concerned, there doesn’t seem to be any rush to sign up for the new individual insurance policies that are the cornerstone of the program. Without a dramatic increase in sales next month, lawmakers say it is unlikely that this state will hit its target of 130,000 policies sold by Jan. 1. And what is more important than a missed sales target is the level of anger they are hearing from the public about canceled policies and skyrocketing costs — it might make you think they’ll ditch insurance altogether.
“The people I am hearing from are talking about their premiums either doubling or being more than that,” said Sen. Linda Evans Parlette, R-Wenatchee. “I am not hearing from happy people.”
The comments came Thursday at a hearing of the Senate Health Care Committee Thursday on the brave new world of health insurance that launched Oct. 1. But this meeting offered a twist on the usual legislative hearing. The most dramatic testimony didn’t come from the state officials who are overseeing the program, but rather from the shellshocked lawmakers who have been dealing with angry calls from back home. As state officials declared they are convinced things will work out for the best, there was plenty of skepticism from the dais. “I hope that will be the case,” said state Sen. Bruce Dammeier, R-Puyallup. “I’m sure that we will find out in the next few months.”
Looking on the Bright Side
The howls that are coming from Washington state are a bit different in tone than those that are being heard nationwide. Most of the rest of the country has been dealing with a barely functional federal health-insurance website. Washington residents have been able to tread a few steps further down the health-reform path because Washington is one of 15 states that has gone it alone in developing its own health insurance marketplace. The Washington state website, known as Washington Healthplanfinder, has been up and running since Day Two. After an enormous glitch that gave everyone who signed up for a subsidized policy an often-wildly low premium figure, the site has been pumping out accurate numbers for the last three weeks. And that has brought Washington residents face to face with the high cost of the new insurance policies that, under federal law, now must be purchased under threat of a fine.
State Rep. Jan Angel, R-Port Orchard, said her phone is ringing off the hook. “They are finding their premiums are going up anywhere from $400 to $700 a month,” she said.
Lawmakers say sticker shock appears to be the norm. And the cause is hardly a secret. Under the new rules imposed by the federal Affordable Care Act and by state regulators, policies now must carry a rich set of mandated benefits, covering things like maternity care and brand-name prescription drugs; for customers over age 30, cheap “catastrophic” policies are banned. Because of the new rules, insurance policies covering 290,000 people are being canceled.
So many who had individual health insurance policies in the past are going to struggle to pay for them in the future. Those of moderate income who couldn’t afford insurance are finding they still can’t afford it. Tax credits are available for those who make less than 400 percent of the federal poverty level, but those who make just over that amount — $44,680 for an individual – may be in for a shock. Even if they purchase the cheapest “bronze” plans, they won’t save much in the end if they have to tap those rich benefits, because they face deductibles of $6,350. And while more generous “silver” and “gold” plans are available, they come with higher monthly premiums.
At Thursday’s hearing, Insurance Commissioner Mike Kreidler told lawmakers that on the whole the new policies are better than the old. “I have a lot of empathy for those individuals who call me, and I am sure you feel the same way, particularly if they feel that the price of the product they have currently in the individual market better fits the family budget.”
He said the cheapest plans that used to be offered provided poor coverage, with no prescription drug benefits and big out-of-pocket costs, as much as $10,000 or $15,000. “This is not coverage that is really going to allow them to protect their families when the worst happens, and no one, no one, is immune from bad luck.” Kreidler notes that 60 percent of the people who purchase individual policies on the exchange will qualify for tax credits.
Crunch Time Coming
It isn’t much comfort for those who do not qualify for those tax credits, however. And lawmakers said many of their callers are staggered by the high costs they have been quoted. “These people are real people, they are getting canceled, and they are not getting something reasonable quoted back to them,” said state Sen. Barbara Bailey, R-Oak Harbor.
For now the complaints being fielded by lawmakers are a matter of anecdote, but by Jan. 1 the picture may be clearer. Canceled policies terminate on Dec. 31, and the following day is when new policies take force, both those sold on the exchange and those sold on the private market. Richard Onizuka, CEO of the Washington health benefits exchange, said the operation is preparing for a rush of business during the month of December, and expects that 50 percent of the qualified health plans sold by the exchange will be sold during that month. It is gearing up for the traffic by doubling the number of workers at the state call center in Spokane, where wait times now average 22 minutes, and have run as long as two hours. Onizuka said the health exchange is doing its best to identify customer-service issues and serve the traffic. “The challenge is we didn’t know what we didn’t know, and we are continuously learning,” he said.
Whether the exchange hits its target of selling 130,000 policies is a matter of importance in its budget calculations and its hopes of becoming a self-sustaining agency by 2015. But lawmakers say there is an even bigger question at stake. In the end, will a law that aimed to insure the uninsured actually increase the number of people who are covered? Or will the high cost of the new program force many to ditch their insurance? It is the number of health plans that are sold that is the issue, not the widely-quoted numbers for those that have signed up for Medicaid, said Senate Health Care Chairwoman Randi Becker. “I have a concern when we have the enrollment numbers we have,” she said.