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Key Findings

1. Governor Inslee has proposed legislation to require a standardized public option health insurance plan in the Washington State Health Benefit Exchange.
2. The exchange is designed to allow patients to purchase health insurance plans using taxpayer subsidies in the individual market.
3. Since 2014, the exchanges in Washington state and nationally have suffered from adverse patient selection leading to instability in the exchanges.
4. HB 1523 and SB 5526 would impose a public option in the Washington State Health Benefit Exchange and would ban private insurance in the Exchange by 2025. A public option is a health insurance plan that is designed by government bureaucrats and largely financed by taxpayers.
5. Provider payments would be at Medicare rates, which are too low to provide timely access for patients to health care, resulting in waiting lists.
6. Many politicians want government-imposed, universal health insurance coverage. Just having insurance, however, does not equate to timely access to health care and treatments.
7. The public option is an incremental step toward a single-payer health care system. 
8. Without a fiscal note, the cost of these bills is unknown to Washington state taxpayers.

Introduction

Governor Inslee has proposed legislation to establish a standardized public option health insurance plan in the Washington State Health Benefit Exchange and to ban private insurance plans in the exchange in 2025. A public option is a health insurance plan that is designed by government bureaucrats and largely financed by taxpayers. In announcing the bill the governor said: 

"…we’re going to do all we can to protect health care for Washingtonians. This public option will ensure consumers in every part of the state will have an option for high-quality, affordable coverage."

The bills to implement the governor’s proposal are HB 1523 in the House and its companion in the Senate, SB 5526.

Background

The Affordable Care Act (ACA), also known as Obamacare, became law in 2010 with no Republican votes. Although taxes began in 2010, the main two benefit payouts of Medicaid expansion and taxpayer subsidies in the ACA exchanges did not begin until 2014. Washington state is one of 12 states that established its own exchange. The exchanges in the other states are either partially or totally run by the federal government.

The exchanges are designed to allow patients to purchase health insurance plans using taxpayer subsidies in the individual market. Plans are grouped in four tier levels, based on the cost of the monthly premium and the number of offered benefits.
Governor Inslee says that: 

"Under the Obama administration and the Affordable Care Act, Washington was able to make tremendous progress in expanding coverage and start bringing down costs in our health care system. Under the Trump administration, all that progress is at risk. Because of the instability they’ve brought to the system, consumers in 14 counties have only one option for coverage and our ability to rein in costs has been stymied."

Download the full Legislative Memo