Legislation could provide alternative under the ACA
By Kendall Heintzelman
Spokane (Wash.) Journal of Business, May 7, 2015
The contested issue of health care coverage and how insurance options will be dictated by employers has a possible solution found in legislation written by Health Care for All-Washington that could go into effect in 2017.
HCFA-WA is an organization that advocates for the reform of comprehensive health care coverage for Washington residents. It’s campaigning for legislation that would create the Washington Health Security Trust, which would be a single public trust fund dedicated to paying for a defined set of health services for residents.
Dr. Daniel Schaffer is a primary care physician in Spokane who has worked at Sacred Heart and Holy Family Hospital. He and Lynnette Vehrs, a registered nurse who has taught as a clinical instructor at Washington State University, are organizers and advocates for the local chapter of HCFA-WA.
Vehrs says the goal with HCFA is “educating the public and the business community” about alternatives to health care financing.
She and Schaffer say HCFA evolved into an association in Washington as a way to pass the health security trust legislation, which was written years ago. They both assert that the trust would be beneficial to employers who struggle with shortcomings in the present health care system, such as rising insurance prices and inadequate coverage leading some people to go without.
Schaffer says health care in the United States has become something of a burden for employers. He says he wants to see health care as more of an infrastructure, so it is fundamental to all citizens.
“Consider health care as an infrastructure and it’ll work better,” he says.
Schaffer describes the current form of health care in this country as “insurance-controlled health care.” He says many people have inadequate health coverage because insurance makes it too costly. Insurance companies lack transparency as well, says Schaffer, and he says the WHST bill seeks to improve transparency.
Schaffer says health care coverage wasn’t intended to be carried on the back of employers, but that is how it has evolved.
Vehrs says employers have to spend a significant amount of time finding a health plan for employees, and says the WHST looks to improve this issue.
The Affordable Care Act allows states to opt out of the federal health care system by 2017 if they come up with their own equal or better method of paying for health care. HCFA-WA is trying to do that with the WHST. Under the WHST, the money spent on health insurance and health care would be put into a trust. The trust would cover health care for all Washington residents without additional revenue, asserts Schaffer, because it would put a cap on the overhead costs of private insurance agencies.
Currently, private insurers have a built in overhead of 20 percent to 25 percent, says Schaffer. The WHST would limit that overhead to less than 10 percent.
This would take away high deductibles and copays, says Schaffer, and without these added expenses, employees would be more likely to visit the doctor rather than waiting to see if health symptoms worsen or subside.
The WHST seeks to provide a defined set of benefits regardless of health or employment status, providing something of a uniform health plan for employees, and therefore Schaffer says an employer “could opt to just not deal with health care at all,” as it already would be covered.
Employers could still provide supplemental insurance for their employees if they wished, he says, but it wouldn’t be necessary.
Under the WHST, the amount of money being allocated to health care would be reduced because what would be needed in the public fund would cost less than paying for private insurance agencies, proponents say.
Schaffer says Massachusetts, Vermont, Colorado, Oregon, and California have similar legislation written or are looking to do the same. He says he hopes this form of health care to will reach a federal level in the future.