Washington State: Board approves Cascade Care (Public Option) Plan Design; here's what's next

via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange Issues Statement on Approval of Cascade Care Plan Designs

Washington Health Benefit Exchange (Exchange) board approved the design for Cascade Care plans today. Cascade Care plans are qualified health plans that have a standard health benefit design across health insurance carriers making it easier to understand and offer more value for Washington Healthplanfinder consumers.

Today, Pam MacEwan, CEO of the Washington Health Benefit Exchange, and Ron Sims, the Exchange’s Board Chair, issued the following statement regarding the approval of the designs as a step in implementing Senate Bill 5526 (Cascade Care):

“Our enduring goal is to ensure that every Washingtonian has access to health insurance coverage that protects themselves and their family. The approval of today’s design of standard plans is a step toward implementing suitable coverage options that are more understandable and of more value to all Washingtonians.

“The Exchange would like to thank the Standard Plan and Plan Certification workgroups, and the many other contributors who helped make this design reality. We look forward to continuing to partner with the Health Care Authority, Office of the Insurance Commissioner and other key individuals in stemming the tide of higher costs and unaffordable deductibles that has prevented many from securing a health plan that met their needs.”

Next steps of implementing Cascade Care include:

  • The Exchange will be working on marketing materials and outreach for Cascade Care informed by focus groups and testing with a goal to develop tools and materials for consumers that will help them in selecting the best plan among their available options based on factors that are important to the consumer –such as, cost, network, customer service, and quality;
  • The Health Care Authority will be initiating a procurement process of public option plans in early 2020. Public option plans are qualified health plans that have a standard benefit design with additional affordability, quality and value requirements; and
  • The Office of Insurance Commissioner will publish filing instructions in spring 2020.

Cascade Care creates new health care coverage options that will be available through Washington Healthplanfinder beginning November 1, 2020 for coverage effective January 1, 2021.

As a reminder: Washington's upcoming "Public Option" doesn't quite match what most people likely think of as a "Public Option", as it's still being administered by a private insurance carrier; it sounds like a closer parallel would be a managed Medicaid plan or Medicare Advantage. And of course, anyone who thinks a PO is going to magically lead to massive savings in & of itself doesn't understand that even fully private insurance carriers are limited to no more than a 15-20% gross margin. The final version of the Washington State PO will be reimbursing healthcare providers at 160% of Medicare rates. In terms of savings to enrollees, I'd imagine perhaps 5-10% on premiums/deductibles/etc would be reasonable.

Having said that, this is still an important move forward for healthcare policy reform.