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Health reform without a mandate: Lessons from Washington state
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| Contributor | RP |
| Last Edited | RP Jun 19, 2012 02:22pm |
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| Category | Commentary |
| Author | Sarah Kliff |
| Media | Newspaper - Washington Post |
| News Date | Sunday, June 17, 2012 02:00:00 PM UTC0:0 |
| Description | If the Supreme Court overturns the health reform law’s individual mandate — a decision that could come as soon as Monday — it won’t be totally unknown territory. For Washington state, it would be quite familiar.
In 1993, Washington also passed a law both guaranteeing all residents access to private health insurance, regardless of their health status, and requiring Washingtonians to purchase coverage.
That never came to be. After Republicans took control of the Washington state House in 1994, the state repealed its individual mandate. The guaranteed issue provision, however, remained on the books.
“The legislature was loath to repeal the insurance reforms because those were very popular,” says Aaron Katz. a health policy professor at the University of Washington, who advised the legislature on the issue. “That put the insurance companies in a bind.”
The bind they were in was this: The only people buying health insurance were those who foresaw having high medical costs. That drove health insurance premiums up. As premiums went up, and insurance became less affordable, enrollment decreased significantly. |
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