Ruby de Luna, KUOW, Author at �鶹Ů�� Health News

Candidates Talk Medicaid In Washington Governor’s Race

Ruby de Luna, KUOW — Thu, 25 Oct 2012 19:00:00 +0000

This story is part of a reporting partnership that includes ,�� and Kaiser Health News.

Medicaid – and how to expand the program – has become an issue in the competitive governor’s race in Washington State.

In June, the U.S. Supreme Court ruled that the Affordable Care Act went too far by requiring states to expand Medicaid or else lose all federal funding for the program that covers the poor and disabled.

The ruling left it up to states to decide whether or not to open up the program to cover more low-income people without insurance. In Washington State, Chris Gregoire, the current Democratic governor, chose to continue with plans for expansion. But Gregoire is not seeking reelection, and whoever is elected governor this fall could change that course.

Inslee (Photo by Ronald Woan via Flickr)

The issue is playing out in an extremely pitting Democrat Jay Inslee, an eight-term congressman from Seattle, against Republican Rob McKenna, the attorney general.

Inslee voted for the health law in Congress and he would follow Gregoire’s lead, expanding Medicaid as mandated by the Affordable Care Act. McKenna says he’s for expansion, but with restrictions. For example, he’d like to require current as well as new Medicaid beneficiaries to share costs.

“We’re only one of the few states where there’s not even a $5 co-pay… what we’re saying is that everyone has to have some financial skin in the game, even just a little bit,” McKenna said.

Currently more than 1.2 million Washington residents get health coverage through Medicaid. Enrollment to the program has gone up since 2008. The state restricts Medicaid to low income children and their parents, people with disabilities, and the elderly.

After expansion,��the program will open up to include adults without children. And eligibility will be based on income. For a single person, that threshold is just under $15,000 in annual income. For a family of four, it’s $30,657.

McKenna (Photo by KCTS 9 via Flickr)

McKenna’s position is not a standard issue Republican stance. He doesn’t support the reform plan put forward by the Republican presidential ticket of Mitt Romney and Paul Ryan. As Washington Attorney General, McKenna joined the lawsuit that challenged the Affordable Care Act, but only the part of the lawsuit that opposed the mandate that most individuals must buy insurance.

The Supreme Court rejected that argument, but McKenna says the Medicaid portion of the ruling gives states some leverage to negotiate with the feds on how to run the program.

Early projections found that about 500,000 Washington residents would qualify under the expanded program, and roughly half of them would enroll.

McKenna wants Medicaid to be maintained as a safety net. But he fears that many employers will stop providing health insurance for their lower wage employees and those people will end up on Medicaid. He wants more flexibility from the federal government to keep that from happening.

“Our goal needs to be keeping as many people on private coverage as much as possible, and not moving as many people as possible on to Medicaid.”

Inslee says the expansion will help people without insurance, but there are fiscal benefits for the state as a whole, too, because right now everyone bears the cost for those who don’t have health coverage.

“We know that when people do not have insurance, they get their health care in one place, and that’s the emergency room,” Inslee said. “Instead of getting routine treatment for the flu, their asthma, or whatever, from a primary care doctor, they go into the emergency room. And that costs four to five times more money to have the same treatment in the emergency room. And you know who it costs—it costs you and me.”

Inslee says those charges are billed to insurance carriers, and the carriers pass on those costs to consumers. He also argues that expanding Medicaid is one way to make sure that federal taxes paid by Washington residents are used to help Washington.

“Look, we’re going to pay these taxes one way or another. This money is going to Washington, D.C. one way or another. The question is where does it go then—does it go just to Florida and California, or does it come back to the state of Washington by hundreds of millions of dollars?”

If Washington continues with Medicaid expansion, the federal government will pick up 100 percent of the tab for the first three years. Over time, the federal match tapers to 90 percent by 2020.

This story is part of a reporting partnership that includes KUOW, NPR and Kaiser Health News.

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Four Want To Be Washington State’s Insurance Commissioner

Ruby de Luna, KUOW — Tue, 07 Aug 2012 15:31:59 +0000

Voters in Washington will be filling out their Vote-by-Mail ballots Tuesday, and they will have a chance to do something that voters in just 10 other states do: elect an insurance commissioner.

The primary field this year includes four candidates, and the top two vote getters, regardless of party, will face each other in the general election.

Whoever wins the office will face a huge undertaking in the coming years as the state implements the Affordable Care Act, which is expected to extend coverage to an estimated 800,000 uninsured people in Washington. The insurance commissioner also has a big role to play in setting up the state’s exchange, the online marketplace where individuals and small businesses can shop for health plans.

, a Democrat, is the incumbent, running for his fourth term. He was an optometrist at Group Health in Olympia, Wash., and a regional director for the U.S. Department of Health and Human Services.

Kreidler says he’d like to continue the work that he has begun and that there is much more to do. “We have essential health benefits to decide. We will be playing a key role with consumer complaints and helping people navigate the new system of health care reform,” Kreidler said. “All of that will fall to our office and that needs to be in place.”

Challenger, a Republican, is an insurance broker, specializing mainly in marine insurance. He has run for insurance commissioner once before and he says if elected he wants to increase competition in the state. Right now, there are three major carriers that offer health plans for individuals and small businesses. He says the state needs to pull more companies into the exchange so customers have more choices.

“When you have a minor source or small number of companies, that’s a monopoly, and I’ve never seen a monopoly give you a good deal,” Adams said.

That’s a sentiment echoed by the other candidates. , also running as a Republican, has been training insurance agents for more than 20 years. He says he wants to create a business-friendly environment to encourage more companies to enter the market in the state.

“The way companies go about becoming authorized in this state is very complex,” Reilly says. “I want to streamline that to see that consumers have greater choices and have more products available.”

Reilly touts his experience in the industry and his deep knowledge of the regulations as qualifications for the job.

Challenger is running as an Independent because he thinks the insurance commissioner’s office should be non-partisan.

Berend owns an insurance agency in Auburn. He’s been in the industry for 30 years. He says that if elected, he would make sure the health exchange is user friendly and accessible. That includes reaching out to people who may not have Internet access.

“I also would like to see, in some of our rural areas in Washington state, weekend kiosks that could be set up in shopping malls or libraries or other public venues,” says Berend. “We could have multilingual volunteers and staff being able to communicate with the citizens and go through the material with them.”

Whoever wins the job of insurance commissioner faces a big task on a tight deadline: The federal health law requires the state exchanges to be ready to be certified by the federal government by October 2013 and open for business by January 2014.

This story is part of a collaboration that includes ,�� and Kaiser Health News.

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Report Offers Glimpse of Health Law’s Impact On Washington State

Ruby de Luna, KUOW — Fri, 01 Jun 2012 19:05:34 +0000

Washington State Insurance Commissioner Mike Kreidler is weighing in on the fate of the Affordable Care Act with a about what’s at stake for Washingtonians if the law is overturned by the Supreme Court.

“There’s so much confusion and misunderstanding out there,” says Kreidler, a Democrat. “This is kind of a heads-up, an early warning that depending on what the court ends up doing, this is what’s in jeopardy for Washingtonians.”

The report finds that:

The uninsured in Washington have grown from 12 percent of the population in 2004 to a projected 16 percent in 2013; from about 700,000 to 1.1 million in raw numbers.
Some 328,000 currently uninsured Washingtonians would gain coverage under the ACA’s Medicaid expansion.
Another 477,400 uninsured residents of the state would qualify for subsidies to buy insurance in the exchanges.

As a state, Washington has an odd relationship to the federal health care law. Democratic Gov. Chris Gregoire supports it, and the state has been working full steam ahead on implementation. Washington received more than $127 million in federal grants to create its health insurance exchange.

On the other side of the issue is the state’s attorney general. Republican Rob McKenna joined 25 other GOP attorneys general to challenge the ACA. He thinks requiring people to buy health insurance or pay a fine is unconstitutional. McKenna also hopes to be Washington’s next governor. (Gregoire is not seeking re-election). But McKenna’s opposition to the law is not as broad as fellow AGs on the lawsuit. He has said he doesn’t support repealing the whole law, but he objects to the mandate for people to buy health insurance.

McKenna by a group of Washington women who contend that he hasn’t represented the state’s position fairly in the federal lawsuit against the ACA. The case scheduled to be heard on June 22.

This post is part of a reporting partnership that includes , and Kaiser Health News.

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