Don’t take away health care choice

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Don’t take away health care choice

By Sen. Linda Evans Parlette

Friday, June 22, 2012

Recently I’ve heard from some of my constituents who were upset to learn they’ll be losing their health insurance coverage on Aug. 1. I looked into the matter and this is what I learned.

LifeWise Health Plan of Washington has been the only health insurer in our state to offer a policy that included catastrophic coverage and a generic-only pharmacy benefit. The plan was popular and affordable and those who contacted me said it was the only insurance they could afford that included a prescription-drug benefit. It worked for them!

When another insurer wanted to offer a plan similar to LifeWise, state Insurance Commissioner Mike Kreidler responded by issuing an emergency ruling prohibiting insurance carriers from offering health insurance coverage that limits prescription drugs to generic medicines. The result is that the 45,000 Washington residents enrolled in LifeWise will no longer have access to the plan they chose and all insurers will be barred from offering these plans in the future — 45,000 people, that’s a lot!

At a time when many people are out of work, health care costs are rising and there is uncertainty about what will happen with the federal health care reform bill, the last thing anyone in state government should do is limit access to health care and consumer choice. It makes no sense.

In 2007, I served on Gov. Gregoire’s Blue Ribbon Commission on Health Care Costs and Access. This bipartisan group was composed of elected officials and agency heads from all areas of state government. One of its recommendations was to give individuals and families more choice in selecting private insurance plans that work for them. Another recommendation was to address affordability of coverage. Unfortunately, this emergency rule seems to run directly contrary to both of those goals.

Now those who had enrolled in the LifeWise plan have three choices: Find money for a higher-cost plan, find a plan that doesn’t include a drug benefit, or drop coverage. I can assure you that this was not what the Blue Ribbon Commission members had in mind when we recommended giving individuals more choices regarding their insurance coverage.

With all due respect Commissioner Kreidler, please revisit your decision and find a way to allow Washingtonians the choice of insurance coverage they want and deserve.

Linda Evans Parlette is a pharmacist and orchardist and represents Washington’s 12th District in the state Senate. She serves as the Republican caucus chair and is a member of the Senate Health and Long-term Care Committee.

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Norm 11 months ago

It doesn't look like Sen Evans Parlette is giving us the full story here. another source says:

"Earlier actions by Premera and Lifewise prompted Kreidler to file an emergency rule on February 15 stating that generic-only prescription drug plans do not comply with Washington law and that all such plans must be replaced by Aug.1, 2012. Companies may still offer products with generic drug coverage, however access to brand name drugs cannot be denied if the person has a medical condition for which there is no generic drug or if the generic drug is not effective.

Certain cancers and mental illnesses, AIDS, rheumatoid arthritis and multiple sclerosis are among the diseases for which no generic drug treatment currently exists"

http://www.examiner.com/article/premera-tries-to-strip-drug-benefits-from-small-employers

H 11 months ago

Norm, what part is Sen Parlette leaving out? . Lifewise says it's a new state rule that prohibits the generic only plan: . * Please be aware that WiseEssentials Rx will be discontinued as of Aug. 1, 2012 because the generics-only prescription drug coverage will no longer be included. This was the only catastrophic plan in Washington that offered any prescription coverage. Due to a new state rule that does not allow health plans to offer generics-only prescription drug coverage, LifeWise decided to remove this benefit to keep our catastrophic health plans more affordable. .

The new law can be seen here: http://www.insurance.wa.gov/laws_regs/documents/2012-04103E.pdf

Annsboy 11 months ago

Why is Washington state determing what types of insurance we can buy in the first place? oh yea...total democrat control, that's why!

Norm 11 months ago

"Norm, what part is Sen Parlette leaving out?"

The part that I quoted.

"Companies may still offer products with generic drug coverage, however access to brand name drugs cannot be denied if the person has a medical condition for which there is no generic drug or if the generic drug is not effective.

Certain cancers and mental illnesses, AIDS, rheumatoid arthritis and multiple sclerosis are among the diseases for which no generic drug treatment currently exists"

The point of the ruling is to insure that when there is no adequate generic drug available, patients still have access to brand name drugs when necessary. There is nothing in the ruling that requires LifeWise to end its generic drug plan, only to modify it.

Annsboy 11 months ago

But their decision eliminates the choice for those who only need generics.

Norm 11 months ago

"But their decision eliminates the choice for those who only need generics"

Yes, LifeWise's decision has eliminated a choice for its present and potential future customers.

Taxguru 11 months ago

No, Lifewise didn't eliminate anything. Insurance Commissioner Kreidler, did. You better reread. Now Lifewise is forced to add more coverage......And of course that means a higher rate.......And of course that means more people will drop their insurance....And of course that means less people paying in.....And that means rates will be jacked up even more, since less are paying in...!!! Another really stupid move by Olympia.

Taxguru 11 months ago

Flame- The non-profit Blue Cross, is just preparing for future increased regulations from Obamacare. Everything from more compliance costs to more capital, machinery, etc. being required. They, being a business, are just being smart and planning ahead. Unlike whatever the Govt runs.....

Taxguru 11 months ago

Oh, yes Flame, you better believe you are picking up the tab for others. More and more people are dropping their insurance as the rates go thru the roof. Thus, leaving a smaller pool to spread costs. It is a VERY sad state of affairs.

Earlier in the week the Liberals and the Conservatives where I comment the most regularly came together for the first time EVER. WE ALL agreed that the SWISS model is the model that the U.S. needs to adopt. It is a win win for everyone and many healthcare pros in the U.S. are advocating the Swiss model also. Unfortunately, politics just keeps dragging this issue on and on with no resolve in sight......The politicians need to vote in a panel of the brightest people, let them cave up somewhere and pen a program, and go with it.

Norm 11 months ago

I find it surprising that TG would support a model that I can also support; but based on the general outline at wikipedia, I can support the swiss healthcare model, too.

"Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Federal Act. It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.[1]

Regulations also restrict the allowable policies and profits that a private insurer may offer, as noted by healthcare economics scholar Uwe Reinhardt in a review in JAMA. Reinhardt writes that, "To compete in the market for compulsory health insurance, a Swiss health insurer must be registered with the Swiss Federal Office of Public Health, which regulates health insurance under the 1994 statute. The insurers were not allowed to earn profits from the mandated benefit package, although they have always been able to profit from the sale of actuarially priced supplementary benefits (mainly superior amenities). Regulations require "a 25-year-old and an 80-year-old individual pay a given insurer the same premium for the same type of policy..Overall, then, the Swiss health system is a variant of the highly government-regulated social insurance systems of Europe..that rely on ostensibly private, nonprofit health insurers that also are subject to uniform fee schedules and myriad government regulations."[3]

Annsboy 11 months ago

It takes little intelligence to see that obamacare will cost insurance companies (us) billions. A person can wait until they have cancer to buy insurance and the insurance company can't deny their short sightedness? This law reduces choice, choice is what drives down cost. If we are to have "universal" health care it should only cover the really large outlays such as cancer, heart attack, overnight hospitalization etc...not something like birth control that costs pennies a day. This could be paid for by a national sales tax so everyone pays not just the "rich" who aren't paying their "fair share" then health care providers should be required to post their fees so the public can compare costs and act accordingly. How many of you would go to a restaurant where the prices were only known when the bill arrived?

Annsboy 11 months ago

Sounds like the swiss modle is a bit like I proposed, no frills.

Taxguru 11 months ago

Exactly Ab, The Swiss plan in a nutshell is this, I will give more if the rain persists, The Govt sets a minimum amount of coverage that non-profits must provide, and then over a hundred of them go to town competing for your business. The Govt stays out of the healthcare business entirely and just regulates. Every person MUST buy and have health insurance from cradle to grave. For the poor and lower incomes the Govt will provide money to help you pay YOUR bill on a sliding income scale.....