Inslee letter provides update on Cascade Care implementation

Gov. Jay Inslee provided an update on the impact of COVID-19 on the implementation of Cascade Care in a letter to Health Care Authority Director Sue Birch and Washington State Health Benefit Exchange Chief Executive Officer Pam MacEwan on Tuesday.



In the letter, Inslee says it is “more important than ever before” to move forward with the state’s public option plan, but warns that it will be a scaled back version in its first year.

“I fully recognize the challenges of introducing such a bold program and understand that this will be a multiyear journey. Our current situation has tested the mettle of our state’s entire healthcare system. While Cascade Care may take a preliminary approach in its initial year, we fully expect it to flourish in future years,” reads the letter.

Inslee’s office frames this letter as simply affirming his support for Washington’s public option during the uncertainty of the COVID-19 pandemic.

A summary from the Public Option Institute, however, notes that this letter comes just days before Phase 2 responses are due for the Cascade Care RFA, and reasons that Inslee’s letter may indicate a lower than expected response rate.

“The potentially scaled-back approach may indicate a lower than expected response rate for Phase 1 responses, which were due on April 17, 2020, in light of the pandemic. Of note, HCA released the RFA for public option procurement on February 27, 2020 – just two days before Gov. Inslee issued a COVID-19 emergency proclamation on February 29, 2020,” reads the summary.

Authors of the POLITICO Pulse newsletter also offered their take, writing,

“The lowered expectations come after insurers complained of difficulty building provider networks, and skepticism from hospitals that would be paid at lower rates under the public option. Five insurers have so far expressed interest in creating public option plans, but it’s unclear where that coverage would be offered.”

HCA is scheduled to announce apparent successful applicants on July 7, 2020. Coverage will begin January 1, 2021.