Michael Ollove, Tribune News Service
When Democratic Gov. Jay Inslee last month signed a law creating a new health plan alternative for Washington state residents, many accounts proclaimed Washington to be the first state with a “public option.”
But the term is difficult to define — even the word “public” is slippery in the context of health care.
“Public option means the government being more prescriptive,” said Chiquita Brooks-LaSure, a managing director at Manatt Health, which provides consulting and legal services in health care. “There’s more of the state weighing in.”
In general, when policymakers use the term “public option,” they mean a health plan with significant government control. That might mean programmes created and operated by government, as Medicare and Medicaid originally were, or programs largely under government control but run by private entities.
Public option is a “squishy term,” said JoAnn Volk, a research professor at Georgetown University’s Center on Health Insurance Reforms. “It does mean different things to different people, depending on your goals and assumptions.”
Whatever form it takes, proponents of a public option believe it would provide consumers with health insurance that is more affordable.
Jason McGill, a health policy adviser to Inslee who helped craft the law, noted that the term “public” in health care has already become muddied in recent years. Medicare Advantage plans — all-inclusive Medicare plans — are offered by commercial insurance carriers, and states contract with insurance companies to run their Medicaid managed care plans
“They are government plans,” McGill said, “but they are run by insurance companies.” Washington state won’t be operating its own health plan. Instead, it will contract with a private carrier — or several — to oversee its public option, which will be on the health insurance exchange alongside commercial plans.
The Washington state plan also will have another layer of rules that officials think will lower premiums. Most notably, the public option plan would set a cap on reimbursement rates paid to providers.
The term “public option” emerged a decade ago during the debate over the Affordable Care Act, when Democrats proposed including a government-run insurance option alongside privately run insurance on the exchanges. But the version of the ACA that President Barack Obama eventually signed did not include it.
Interest in the idea endured, however. In 2017 and 2018, the cost of private plans on the exchanges soared in many parts of the country, prompting at least 15 states to reconsider a public option through a so-called Medicaid buy-in.
The breakthrough on the public option finally came last month in Washington when Inslee, who is running for the Democratic presidential nomination, signed the public option into law. Premiums in Washington have increased by more than half over the past two years, but McGill said that wasn’t the only impetus for the law.
Only 61% of Washingtonians who buy insurance on the marketplace qualify for federal aid in the form of premium tax subsidies. That compares with 87% nationally.
Under the law, Washington must contract with at least one private carrier to begin offering a public option in the year 2021. Under the contract, the carrier would have to meet state requirements related to transparency, administrative costs and purchasing that do not apply to other carriers.
McGill said the goal is to keep premiums for the public option at least 10% lower than what commercial carriers charged the previous year. To do that, the state will limit reimbursement rates to no more than 160% of what Medicare pays.
Trade. Tariffs. Talks collapsing before they begin. Politicians, diplomats and negotiators sniping at each other. No, not Brexit (just for a change) but the US-China trade war.
President Donald Trump couldn’t wait to arrive in Iowa on Tuesday before attacking Joe Biden. And vice versa. With the presidential rivals crisscrossing the state that holds the first contest of 2020, the acid back-and-forth offered a preview of a possible general election matchup — and a cautionary tale of how much vitriol the race
To make America happy again, society has to figure out how to make our country whole. Understanding what divides Americans — and what gives them hope —could be critical to improving their well-being and the nation’s. By tracking patterns in well-being, and creating programmes based on the results, we can take steps
In early June, an unnamed adviser to Democratic presidential candidate Bernie Sanders used the anonymity afforded to him by a reporter to berate one of Sanders’ main competitors: Elizabeth Warren. Speaking with US News & World Report, the adviser, whose comments were described by many as “cutthroat”
The choosing of Dubai as the ‘’Capital of Arab Media’’ for the year 2020 by the Arab Information Ministers Council is a well-deserved accolade for the dazzling Emirate.
A cunning rat leaves a sinking ship. Yet it’s a striking feature of today’s Conservative Party that so many are scrabbling to stay aboard their listing vessel instead. Amber Rudd and the ever versatile Matt Hancock have even converted to the cause of a crash-out Brexit, despite previously warning it would be the economic equivalent of scuttling your own fleet at Scarpa Flow.
President Donald Trump’s vicious verbal assaults on four women of colour who are members of Congress have sparked an avalanche of well-earned criticism, including from some of his supporters. As regular readers know, I’m fascinated by history, so I’ve been wondering where Trump’s tweeted comments rank among the most racist ones made by presidents (or successful presidential candidates) during my lifetime.
A lot of people are beginning to think that there is a conspiracy going on against the elderly. Some think that product manufacturers seem not to care, or even forget, that their consumers also comprise people who are older. This criticism has recently been levelled against makers of anti-ageing products.