Kreidler on Supreme Court case and the state health-care exchange

Commissioner Kreidler sat down with TVW's Christina Salerno yesterday for a Q&A on health care reform, including this week's three days of arguments in the U.S. Supreme Court and the shape of the state's upcoming Health Benefits Exchange.

From the discussion:

What would change if they overturned the act?

People are directly benefiting from parts of the act today. People can stay on their parents’ insurance until 26, they can get preventive care with no deductibles — all of that would go away. (Attorney General) Rob McKenna’s lawsuit would undo all of that. The entire law may go down. We’d be back to square one, which is a system that’s failing us as a country and as a state. For many individuals, it was making a difference between life or death decisions.

State website access.wa.gov among the top nationwide

Well-deserved kudos to the folks who run Access.wa.gov, a Washington state website that helps make much of what government is doing available on one easy-to-navigate site.

The Sunshine Review, a nonprofit group focused on government accountability, recently awarded the site with an A+ grade, meaning that it's one of the most accessible state government sites in the country. From the group's report card on the site:

Elected officials are listed with contact information
Budgets are posted
Audits are posted
Contracts are posted in a searchable database
The site includes information on requesting public records
Lobbyist lists and reports are posted in a searchable database
etc.

(And a hat tip to The HDC Advance for the heads up on this.)

How to appeal when your health insurer says no

Seattle's KING 5 TV recently did a story on the case of a Tacoma man diagnosed with stage 4 cancer. After trying other treatments, his apparent only remaining option is an experimental anti-cancer drug that his insurer refuses to cover.

He contacted our office, and we're helping him navigate the appeals process. Many people don't realize that a denial by your health insurer is not the final word on the matter. There are multiple rounds of appeals available, including to what's called an "independent review organization," which is a group that has the power to require your insurer to cover a treatment or procedure. And more than a quarter of the people who appeal to an independent review organization win.

How to appeal the decision? We've put together a detailed appeals guide with sample letters to send your insurer. Take a look -- and don't give up.

Here's the story from KING 5:

Hearing next week on Humana's request to acquire Arcadian Health Plan

From our public notices web page:

The Insurance Commissioner has scheduled a hearing for March 27, 2012 at 10:00 a.m. Pacific Time in his Tumwater, Washington office to consider whether he should approve or deny Humana Inc.’s request to acquire Washington-based Arcadian Health Plan, Inc.

Arcadian Health Plan, Inc. offers Medicare Advantage health products through the federal Centers for Medicare and Medicaid Services, and is wholly owned by its parent company, Arcadian Management Services, Inc. Arcadian Management Services, Inc. is currently owned by five venture capital investment funds affiliated with Morgan Stanley Dean Witter, and by Arcadian employees. Humana Inc. proposes to purchase the parent company and all of its subsidiaries including Arcadian Health Plan, Inc.

Humana Inc., which had $36.8 billion in revenue in 2011, and has 11.2 million covered individuals in its medical plans and another 7.3 million in its specialty plans nationwide, is proposing to acquire all outstanding stock of Arcadian Management Services, Inc.. If approved, Humana Inc. would wholly own Arcadian Management Services, Inc. and all six of its subsidiary health carriers including Arcadian Health Plan, Inc.; Arkansas Community Care, Inc.; Arcadian Health Plan of North Carolina, Inc.; Arcadian Health Plan of Georgia, Inc.; Arcadian Health Plan of Louisiana, Inc.; and Arcadian Health Plan of New York, Inc.

The public is notified that all interested parties may submit letters of support or objections and/or may participate in the hearing by appearing in person or by telephone. To view the Notice of Hearing, which includes advice on how to participate and other related documents, go to http://www.insurance.wa.gov/orders/hearings_proceedings.shtml

Our complaint- and rates Web applications will be down over the weekend

Two of our most popular Web applications will be off-line this weekend because of scheduled maintenance to our imaging software.

From 5 p.m. Friday until 8 a.m. Monday, these two systems will be down:

• Online complaint filing (where consumers can file complaints against their insurance company)
• Our health insurance rate request lookup (where you can see which insurers have filed proposals to increase health insurance premiums)

Thanks for your patience and understanding.

Health care reform: Two years later, what's changed?

From a press release we put out this morning:

The Affordable Care Act’s most controversial component – the mandate requiring everyone to have health insurance – is still two years away. But two years after the law’s enactment, many Washington consumers are quietly benefitting from many of the laws lesser-noticed provisions.

“The Affordable Care Act’s individual mandate gets most of the attention, but it shouldn’t overshadow the success stories of the early reforms,” said Insurance Commissioner Mike Kreidler. “By far the most popular benefit of health reform that we hear about is the ability for parents to keep their adult kids on their health plans – especially in today’s economy – and there are many more.”

Among the changes that have already taken effect here in Washington state:

■More than 2.4 million Washingtonians no longer face lifetime limits on their health benefits.

■More than 52,000 young adults up to age 26 have been able to stay on their parents’ health plans.

■More than 1.2 million Washingtonians now have coverage for preventive care with no co-pays or deductibles.

For much more information about what's changed and is changing, click on the link above.

Where -- and why -- to find flood coverage

Another post for National Flood Safety Awareness Week: Here in the rainy Northwest, we can't say this often enough: a standard homeowners insurance policy does NOT cover flooding.

The good news is that flood insurance is widely available through the National Flood Insurance Program. It's a federally run insurance program, but sold by local agents and brokers. For most homeowners, the NFIP is the first stop for flood coverage.

If you live in an area with a high chance of flooding (a "Special Flood Hazard Area"), your lender will generally require you to have flood insurance. Even if you live in a minimal or moderate flood hazard area, you may still want to buy it.

There are, however, limits to federal flood insurance. For commercial structures, for example, the NFIP maximum is $500,000 for the building and $500,000 for the contents. Businesses also may need additional coverage that isn't available through the NFIP, such as business interruption coverage.