Senate approves health care exchange bill

OLYMPIA – Despite Republican objections that it was moving too fast, and reported threats of political reprisals, the Senate approved changes to a system of shopping for medical insurance that supporters liken to Internet sites such as Travelocity.

By a 27-22 vote, senators set new rules for the state’s fledgling health care exchange, which is being set up in conjunction with the federal Affordable Care Act.

Sen. Karen Keiser, D-Kent, said the new rules will lead to a system for Washington residents who don’t have health insurance through their jobs to shop for it easily on the Internet, as people now compare airfares and hotel rates on sites like Travelocity or Expedia. It will also have a rating system, similar to Consumer Reports, to help shoppers choose the best plan.

The state currently has about 1 million residents without insurance, and this would help about 300,000 find plans they could afford, Keiser said. The state also could qualify for as much as $100 million in federal aid when the Affordable Care Act takes effect.

Health care exchanges are part of federal health care reform, but the system the Senate approved goes further than federal law in what it requires insurance companies to offer. Sen. Randi Becker, R-Eatonville, introduced an alternative approach that would have the state going slower on setting up the exchange and mandating fewer services for insurance plans to cover. Her amendment failed, 22-26.

“Federal health care reform is a moving target. There is nothing that we can hang our hats on,” Becker warned.

But Sen. Cheryl Pflug of Maple Valley, one of the few Republicans to back the final version, said the state should “do it our way” rather than stick solely to federal guidelines.

“People say the sky will fall if we reform. The sky is already falling,” Pflug said, adding she was appalled that some legislators were receiving notes from opponents of reform that there would be “consequences” to senators who voted for the bill.

The state’s rules were necessary to keep insurance companies from “cherry picking” the market, said Sen. Jim Hargrove, D-Hoquiam. That’s a term for offering low-cost, bare bones policies to young, healthy residents and leaving the state with older, sicker residents who can’t afford the expensive plans they’re offered.

But Sen. Doug Ericksen, R-Ferndale, said the rules go too far, making the exchange an expansion of government that will drive up costs. “Expedia was created by the private sector,” he added.

The Senate bill goes back to the House, where Rep. Eileen Cody, chairwoman of the Health Care and Wellness Committee, said she expected the new version to pass.

Work on the exchange starts this month, but the final system isn’t scheduled to be up and running before fall of 2013. By then, legislators can expect a ruling from the U.S. Supreme Court on whether the Affordable Care Act is constitutional, and another session with new members elected in the November elections.

Some revisions likely will be needed next year, Keiser said: “Every piece of heavy lifting takes refinement. This is akin to trying to build Social Security on a state level.”