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2019 House Bill 1523: Increasing the availability of quality, affordable health coverage in the individual market
Introduced by Rep. Eileen Cody (West Seattle) (D) on January 23, 2019
Referred to the House Health Care & Wellness Committee on January 23, 2019
Substitute offered in the House on February 15, 2019
Requires the Washington Health Benefit Exchange to develop standardized health plans.
Referred to the House Appropriations Committee on February 19, 2019
Referred to the House Rules Committee on March 4, 2019
Amendment offered by Rep. Michelle Caldier (Port Orchard) (R) on March 8, 2019
Allows an individual to purchase individual market coverage across county lines within the same geographic rating area.
The amendment failed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Michelle Caldier (Port Orchard) (R) on March 8, 2019
Lowers the modified adjusted gross income of individuals for whom the Exchange must develop a premium assistance plan from 500% of the federal poverty level to 300% of the federal poverty level.
The amendment failed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Eileen Cody (West Seattle) (D) on March 8, 2019
Allows, instead of requires, a qualified health plan offered pursuant to a Health Care Authority (HCA) contract to use a managed care model. Requires a qualified health plan offered pursuant to a HCA contract to: (a) meet additional participation requirements to reduce barriers to maintaining and improving health and align to state agency value-based purchasing; (b) employ utilization review processes that meet national accreditation standards, align with HCA-published criteria, and are focused on care that has high variation, high cost, or low evidence of clinical effectiveness; and (c) have a medical loss ratio of at least 90%. Removes the request for qualifications process in which the HCA must contract with all health carriers that meet the minimum qualifications.
The amendment passed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Joe Schmick (Adams) (R) on March 8, 2019
Removes the underlying provisions of the bill dealing with standardized health plans, state-contracted health plans, and the development of a plan to implement premium subsidies. Instead, allows an individual to purchase individual market coverage across county lines within the same geographic rating area and exempts health plans from all state-mandated benefits outside of what is required under federal law.
The amendment failed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Joe Schmick (Adams) (R) on March 8, 2019
Removes the phase-out of non-standardized plans offered on the Exchange and instead allows non-standardized plans to be offered on the Exchange without limitation..
The amendment passed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Eileen Cody (West Seattle) (D) on March 8, 2019
Requires the Exchange and the Office of the Insurance Commissioner to analyze the impact to Exchange consumers of offering only standard plans beginning in 2025. Requires that the actuarial value of non-standardized silver health plans offered on the exchange be no greater than the actuarial value of the standardized silver plan with the lowest actuarial value.
The amendment passed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Joe Schmick (Adams) (R) on March 8, 2019
Requires the Insurance Commissioner to submit an annual report to the Legislature on the number of health plans available per county in the individual market.
The amendment passed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Joe Schmick (Adams) (R) on March 8, 2019
Requires the Insurance Commissioner to submit an annual report to the Legislature on the effect each state mandated benefit has on the cost of coverage.
The amendment failed by voice vote in the House on March 8, 2019
Amendment offered by Rep. Joe Schmick (Adams) (R) on March 8, 2019
Requires the Insurance Commissioner (Commissioner), instead of the Health Benefit Exchange (HBE), to establish the standardized plans.
The amendment failed by voice vote in the House on March 8, 2019
Requires the Washington Health Benefit Exchange to develop standardized health plans. Requires the Health Care Authority to contract with health carriers to offer standardized qualified health plans. Requires the Health Care Authority to develop a plan for premium subsidies for individuals purchasing coverage on the Washington Health Benefit Exchange. Requires the Insurance Commissioner to submit an annual report on the number of health plans available per county on the individual market.
Received in the Senate on March 12, 2019
Referred to the Senate Health & Long-Term Care Committee on March 12, 2019
Amendment offered in the Senate on April 1, 2019
Directs the Insurance Commissioner to annually review the standardized plan designs and provide written comments to the exchange and the chairs of the Senate and House of Representatives health care committees. (2) Removes the ability for qualified health plans contracting with HCA to be offered in a single county. (3) Removes the requirement that the qualified health plans contracting with HCA have a medical loss ratio of at least 90 percent. (4) Removes the requirement that the qualified health plans contracting with HCA reimburse providers and facilities at a rate that does not exceed the Medicare rates. (5) Directs HCA to consider the rates, utilization management policies, pharmaceutical costs, and other factors proposed by the carrier or carriers, with the goal of negotiating for plans that reduce premiums below the average premiums in Washington during plan year 2019. (6) Removes the null and void clause.
Referred to the Senate Ways & Means Committee on April 3, 2019
Referred to the Senate Rules Committee on April 9, 2019