State Roundup: WA tries to stop gender identity discrimination, NV pushes for year-round enrollment, & you won't believe the latest craziness out of VA...

Three stories which didn't seem worthy of their own full blog entry but each of which are pretty interesting...

Washington State, 06/25/14: Kreidler calls for health insurers to end discrimination based on gender identity

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is asking all health insurers doing business in Washington state to end discrimination in health insurance based on gender identity and related medical conditions.

In a letter sent to health insurers this morning, Kreidler reminded health insurers that exclusions and denials of coverage on the basis of gender identity are against the Washington Law Against Discrimination (RCW 49.60) and the federal Affordable Care Act (Section 1557).

...“Transgender people are entitled to the same access to health care as everyone else,” said Insurance Commissioner Mike Kreidler. “Whether specific services are considered medically necessary should be up to the provider to decide on behalf of their patient.”


Nevada, 06/25/14: Nevada Pushes Year-Round Enrollment To Plug Gaps

Nevada is rolling the dice on adverse selection. Since January, insurers that sell individual health plans off the state’s public exchange are now required to offer those options year round. However, a 90-day waiting period can be imposed to discourage people from waiting until they get sick or are in desperate need of immediate care to buy a plan.

“No other state allows this, but I think it is a good thing,” says Vickie Mayville, president of the Nevada State Association of Health Underwriters and owner/broker at Mayville Incorporated Health Insurance Agency in the Las Vegas area. She surmises that some states may attempt to follow Nevada’s lead.

Nevada Assembly Bill 425 passed in 2013 with assistance from the Nevada Division of Insurance, which recognized that some consumers may need or want to buy health insurance off the exchange without having had a special qualifying event.

I don't know enough about what the real-world actuarial impact on year-round enrollment would mean, but the Nevada insurance industry seems to be surprisingly UNopposed to it (at worst, they seem to be shrugging off the potential downside). It seems to me that you could achieve the same goal by reducing the uninsured "grace period" for non-coverage from 90 days down to, say, 30 or 60, and/or bumping up the tax penalty a bit more (although that's already in the works; it's 1% the first year but will eventually move up to 2.5% over the next couple of years).

Virginia, 06/24/14: Capitol police gave House clerks access to governor's office

At the urging of House Speaker William J. Howell, the clerk’s office of the House of Delegates enlisted the help of the Capitol Police to enter Gov. Terry McAuliffe’s unoccupied, secure suite of offices on a Sunday afternoon to deliver the state budget.

The highly unusual entry on June 15 took place without the permission of administration officials or the knowledge of the Virginia State Police, which is in charge of protecting the governor. McAuliffe was not in the building.

"Highly unusual entry" is one way of wording it. Another might be "breaking and entering at the Governor's office". Basically, the Viriginia Republican Party, having already potentially committed a felony in order to prevent 400,000 of their own constituants from receiving decent healthcare, may now committed an additional misdemeanor, not that I expect either of these to be seriously pursued. Why did they pull this latest stunt?

Once the clerk’s office enrolls a budget and delivers it to the governor, the statutory clock starts ticking. The governor has seven days to take action on the spending plan.

Ah, of course. This reduced the amount of time that Gov. McAullife has to review the state budget before signing it into law. The pettiness of the VA GOP is stunning, but what else is new?