5 Things Washington: Executive order, Rick Weaver, HBE financials

This could be the week where President Trump releases a consequential executive order that undermines the commercial markets both on and off the exchange. Or, not.  It’s hard to say how things will play out given DC’s inability to substantively and successfully deal with health policy.

So, we’ve got that and a few other things for you to watch this week in Washington State health care.

DJ 5 Things Signature


1.  Exec order on insurance coming Thursday

President Trump is reportedly set to sign an executive order on Thursday that will loosen restrictions on association health plans and short term medical plans. The WSJ reports the intent is to provide lower cost solutions to the insurance market, and allow for cross-border sales of products through associations. However, the same article suggests market stability could suffer.  Vox argues the same, and cites Tennessee as an example of how this might turn out.

We asked insurance regulators and executives in a few states for comments, and compiled their responses here. California’s Insurance Commissioner is ready to go to courtHawaii and Alaska are worried about the impacts of policy uncertainty on the markets.  Commissioner Mike Kreidler believes that state law would likely overrule an executive order.


2.  Video:  Rick Weaver on integration

Rick Weaver has been on both sides of the public/private sector divide. He’s leaving his role as CEO of Comprehensive Healthcare, the BHO for much of central and south eastern Washington State. He is stepping into a role with Gov. Jay Inslee’s office where he will be a key health policy adviser in support of furthering integration in Medicaid. Rick is featured in this edition of “What They’re Watching,” where his comments are both informed and candid.

“I think a lot of providers, RSNs, BHOs, have chosen to ignore it (integration)…  The reality is integration is here. It’s the law of the state and it’s moving ahead.  You gotta get ready for it, and you can’t just do that in a week.  You gotta start planning now.”



3.  Four takeaways from the latest HBE financials

The Washington Health Benefit Exchange released a report to the legislature on September 30th that provided some detail about the current operational and financial state of the agency.  If you followed the financial reporting of the HBE back in the early days, you know the reporting wasn’t always as clear and transparent as it could have been.

I spent some time with the 34-page document, as well as a host of other financial and operational reports from the Exchange.  I offer four takeaways from that review here.  But, my bottom line view would be this:  I think Pam MacEwan and Carole Holland deserve significant praise for their turnaround of the agency. It’s success that shows in this report.


4. 2017 Re-Wire Policy Conference Topical Agenda

Our sister site, the Washington State Wire, covers regulated markets across the Washington State economy and policy world. Where State of Reform is one issue across multiple states, the Wire is one state with multiple issues.  But the work there is deeply informed by the success we’ve had with State of Reform.  It’s a non-partisan, policy agnostic platform that attempts to bridge the gap between regulated markets and regulating agencies.

Today, the Wire released it’s Topical Agenda for the 2017 Re-Wire Policy Conference.  The conference agenda will look similar in framework to what you’re used to at State of Reform, but it’ll cross the entire scope of the potential topics ahead in the 2018 legislative session. The event is coming up on December 12th in SeaTac.

We’d be thrilled to have you.  And, anyone that signs up to attend the Re-Wire Policy Conference will get a discount code for $100 off our 2018 Washington State of Reform Health Policy Conference on January 4th. So, you’ll be able to save a few bucks!


5.  Two podcasts on Medicaid transformation

We have two podcasts for you if you’re interested in what folks are saying about system transformation in Washington State.  The first one is on the “Post-ACA system in Washington State.” This discussion features MaryAnne Lindeblad, Washington’s Director of Medicaid; Pam MacEwan, the CEO of the Exchange, and Sue Lani Madsen, a columnist with the Spokesman Review.  This was recorded at our recent Spokane conference and edited for length.

The second is on the question of transformation in Eastern Washington specifically. I moderated this discussion that included Craig Smith, President of Amerigroup; Commissioner Mike Manus from Pend Oreille County, and Antony Chiang, CEO of Empire Health Foundation. This was also recorded via video, but if you’re a podcast geek, like me, you’ll appreciate this audio version.