5 Things Washington: Jim Polo, MD, Pam MacEwan, Tribal health

These are epic days of long summer days in Washington State. Try to get as much vitamin D as you can – while you can. If you’re otherwise looking to brush up on your health policy, we’ve got a few things for you in this edition of 5 Things for June, 2019.


With help from Emily Boerger


1. Pam MacEwan testifies before Congress

This morning, Pam MacEwan, CEO of the Washington Health Benefit Exchange, testified before the US House Ways and Means Committee regarding the Affordable Care Act (ACA) and Washington State’s progress in the health care arena. Her comments to Congress covered Medicaid expansion, state efforts toward market stability, and the the status of Washington’s public option. More importantly, her testimony came within the context of the Democratic Party, in general, trying to discern whether to build upon the ACA, or wipe it away with a Medicare-for-All” approach.

“I hope Congress can look to Washington state as an example of how progress can be made when lawmakers, advocates, carriers and delivery system partners work together on data-driven, actionable solutions,” testified MacEwan. Her full written testimony is available here.


2. Early-bird registration closes Friday

Our Early Bird rates end later this week ahead of our 2019 Inland NW State of Reform Health Policy Conference. It’s one step in a three month process leading up to September 10th and this year’s event. Our Convening Panel is reviewing and commenting on our Draft Topical Agenda now. We’ll have that ready for you to review a little sooner than normal, I think.

Thanks to our early sponsors of this year’s conference. It’s a great list of folks so far: AmerigroupWSUEmpire Health FoundationHMACoordinated CareKaiser PermanenteBeacon Health OptionsMolina HealthcareCommunity Health Plan of Washington and EWU! This is a tremendous list of some of Eastern Washington’s most esteemed health care brands – a group from which we’re very thankful to have so much support!

3. Legislation on tribal health

The “Washington Indian Health Improvement Act” passed this session in what is a thoughtful, structural approach to making improvements to support native and tribal health. Laura Lundberg and Sara Gentzler report on it here. In 2016, CMS told the state that some Medicaid services for American Indian and Alaska Natives (AI/AN) could be 100% covered by the federal government. This would replace the existing federal contribution, ranging from 50% to 90%, depending on eligibility.

That meant the State of Washington could save between 10%-50% on the cost of AI/AN beneficiaries. Rather than lose those dollars to the general fund, Sen. John McCoy and a bi-partisan group of sponsors directed that the savings be directed back into tribal health. A new Indian Health Advisory Council will oversee and govern the expenditures. Tribal leaders will join a caucus member from each of the four corners on the Council. It will be a significant source of new funds for AI/AN health care in the state.

4. Video: James Polo, MD, Regence Blue Shield

James Polo, MD is the Behavioral Health Medical Director at Regence Blue Shield. He joins us in this edition of “What They’re Watching” to discuss behavioral health integration. Regence has made significant steps forward on behavioral health in recent years, including bringing Polo on board last year.

“It’s not about hiring a few smart people in behavioral health; it’s how do we generate, kind of, an entire organization that recognizes that everybody touches behavioral health in some way… We’re really engaging in the idea that everybody needs to be a part of this new engulfment of saying that behavioral health is a key component of health care.”


5. A first look at rate request changes for 2020 plans

Last week, Washington Office of the Insurance Commissioner released a first look at the requested rates for the 2020 individual health insurance market. Early takeaways: thirteen health insurers filed a record-low proposed rate increase of .96%; two new insurers are joining the market; and all 39 counties have at least one insurer selling on the Exchange.

The rates changes range from -7.26% (Premera Blue Cross) to 10.16% (Coordinated Care Corporation). “This year’s filings are evidence that our full adoption of the [ACA] and the steps we’ve taken to defend and preserve it are stabilizing our market,” said Insurance Commissioner Mike Kreidler. “We have more work to do to lower the cost of health care and to help lower out-of-pocket costs, but these proposed rates are welcome news.”