Kreidler’s reinsurance and surprise billing proposals fail to pass this session

Two proposed bills from Insurance Commissioner Mike Kreidler that sought to help consumers with medical costs failed to pass the Washington state Legislature this year.

Engrossed Substitute House Bill 2114 would have prevented people with insurance coverage from receiving a surprise medical or ‘balance’ bill when they went to an in-network medical facility but were treated by an out-of-network provider. The bill passed the House of Representatives but stalled in the Senate.

“Everyone agrees that consumers should not be caught in the middle of these billing disputes,” said Kreidler. “I’m very grateful to Rep. Eileen Cody, D – Seattle, for her leadership on this issue. We are confident that we had a fair payment formula worked out, but the insurers and providers – especially some medical specialties – disagreed. We will continue to work on this issue during the interim. In the meantime, until we can reach an agreement, consumers will continue to be harmed and I don’t think that’s an outcome anyone wants.”

The Legislature was committed to working on Kreidler’s proposal (HB 2355/SB 6062) to create a state-based reinsurance program to help stabilize the individual health insurance market but in the end, could not agree on a financing source for the program.

Kreidler pursued this legislation to help shore up the individual health insurance market where more than 300,000 Washingtonians buy their own health coverage.  Last year, this market initially had two counties with no insurer – Klickitat and Grays Harbor.

“While I’m disappointed that we couldn’t get a reinsurance program enacted for our consumers, we are taking other important steps to ensure consumers in every county will have access to coverage,” said Kreidler. “People who buy health insurance in the individual market have no negotiating power. It’s up to us to make sure that we’ve done everything we can to provide them with a choice of as many affordable health insurance options as possible.”

Kreidler recently initiated rule-making to help stabilize the individual market and encourage insurers to provide coverage in more counties in the state, especially in rural areas. Also, the Legislature passed HB 2408 to make sure consumers in all counties will have access to an individual health plan.

Under HB 2408, for 2019, if no health plan is available in a particular county, people can enroll in the state’s high risk pool, WSHIP, and receive a premium discount. In 2020, insurers that contract with the state to offer coverage to school employees must also offer an individual plan through the state’s Exchange in their area. In future years, this would apply to insurers that also provide coverage to state employees.