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.
Resident Jordan Lewis described the Belhaven neighbourhood as a quirky one, with residents decorating road signs and putting Christmas trees in potholes.
"The Lion King" maintained its reign over North American theaters, taking in $76.6 million over the three-day weekend, industry watcher Exhibitor Relations said Monday.
Wells Fargo & Co’s plan to bring in an outsider as its next chief executive could give the scandal-plagued bank a much needed fresh start, but a turnaround will not be easy for whoever takes the helm, analysts said. The fourth-largest US bank by assets said on Thursday that CEO Tim Sloan, a 31-year Wells Fargo veteran, would resign immediately and a committee would meet on Friday to start looking for a replacement from outside the bank.
While growing intolerance poses a mammoth challenge to many nations, it is a matter of great pride and honour for citizens and residents of the UAE that the country sets flawless examples on what a truly tolerant
Day two of conference in sunny Brighton, and UK Labour’s Brexit policy is about to be decided. Tonight is the important composite meeting, where the final text of Labour’s policy will be decided upon by delegates
With Labour party conference in Brighton this week climate will be at the top of the agenda. One-hundred and twenty-eight constituencies have submitted the Labour for a Green New Deal motion to Labour