Washington State Medicaid Managed Care Plans Left Out of Health Care Exchange

Washington Office of Insurance Commissioner Mike Kriedler made a bad decision more likely to adversely affect the poor, elderly and people of color populations.

The Affordable Care Act requires everyone to have health coverage.  The uninsured in our state can choose from plans under the new WA Health Benefits Exchange (The Exchange) as approved by the WOIC.   Healthcare insurance providers Bridgespan, Group Health Cooperative, Likewise and Primera Blue Cross were selected.  NONE of the Medicaid managed care plans that applied, CHPW, Molina and Coordinated Care, were selected. 

Vulnerable populations such as the poor, elders, people of color are and will be adversely impacted, including populations and others served by community health centers such as ICHS and SeaMar patients. 

The lack of Medicaid managed care providers in the Exchange is problematic because it:

-- Cost Prohibitive – The selected plans are commercial plans with premiums higher Medicaid plan premiums. In many situations, said premiums are higher than the penalty for remaining uninsured.  Therefore most uninsured people are likely to forego coverage and just pay the penalty, defeating the goal of the Affordable Health Care Act. 

-- Adversely Affects Low Income and Minority Populations – This decision has the greatest impact on minority and low-income populations, many of whom are currently being served by community health centers. 

-- Disrupts Continuity of Care – Medicaid patients go on and off of Medicaid as their incomes change. Community health centers see a significant number of Medicaid patients.  When these patients become ineligible for Medicaid due to increased income, they will have to enroll in another plan.  This means they may no longer be able to see their primary care provider where they have established care.

-- Disrupts Whole Family Care – Many of the uninsured have children who are on Healthy Options and are covered by Medicaid.  Without the Medicaid plans being included in the Exchange, families will not have the choice of all members being seen by the same provider or clinic. 

-- Loss of Additional Benefits – Patients seen at the community health centers have additional enabling services that the private commercial plans do not offer.  These services include language interpretation, eligibility assistance, health education, nutrition, social work, chronic disease management, dental services, mental health services, etc.  ALL the services that make ICHS a true health care home for our patients.

-- Limits Choice – Part of implementing health care reform is to ensure people have choice when selecting their health plan coverage.  Excluding the Medicaid managed care plans from the Exchange extremely limits the choice for many patients.  There are a number of areas in our state where there is only ONE Exchange plan available to patients.  This does not constitute choice. The community health centers services and the Medicaid managed care plans are offered in at least 30 of the 39 counties in Washington.  Including the Medicaid plans would provide much more choice for patients across the state. 

We ask that you, your family and friends let Mike Kriedler, Insurance Commissioner know that his decision is not acceptable.   

Tell him of the community concerns, your story and give him the message that

"Leaving Medicaid plans out of the Exchange jeopardizes our community members' ability to have continuity of care and continuity of coverage.  Please include Medicaid plans as a choice in the Exchange."  

Email [email protected] or leave a phone message at 360-725-7171 or 360-725-7009.