Letter to the Editor: Congressman McDermott responds

To the Editor: 

Thank you for publishing my email message to my constituents about the upcoming Health Insurance Marketplace (“the Exchange”) open enrollment, beginning October 1, 2013. I’d like to respond to the comments of Jeff Lindstrom, published the following day. 

Mr. Lindstrom points out that insurance carriers may change their plan offerings to meet the more rigorous coverage standards established by the Affordable Care Act. In the past, insurers could offer plans with very low premiums but dangerously inadequate coverage; these packages had unreasonable lifetime limits, few covered essential services like maternity care, preventive services or even hospitalization, and some excluded pre-existing conditions. Under the new Affordable Care Act, plans must be worth their premiums. Mr. Lindstrom suggests consumers will not have sufficient choice when purchasing insurance on the Exchange because only four insurers are participating in the Washington Exchange. But those four insurers will offer 31 plans to provide a full range of premium costs and coverage options. Though Mr. Lindstrom correctly points out that there are no “platinum” plans in Washington State for 2014, that option is available should insurers decide to offer it. With sufficient demand, carriers no doubt will elect to do so. 

Mr. Lindstrom contends that “giving discounts to small ‘Healthy’ employer groups in Washington is now no longer allowed” by the ACA. In fact, the ACA creates new incentives to promote employer wellness programs. And this ACA provision also is structured to protect consumers from unfair practices related to their health conditions. 

Similarly, Mr. Lindstrom’s assertion that “No Washington Insurance companies have issued rebates for individual policies” is incorrect. Insurers that have issued 2012 rebates in the State of Washington include Regence Blue Cross Blue Shield of Oregon and Trustmark Life Insurance Company. Interestingly, Washington boasts the highest average rebate for the individual market, as seen here.

I will conclude by addressing Mr. Lindstrom’s opening remark that Congress has “exempted themselves” from the requirements of the Affordable Care Act; he alleges that Members of Congress and congressional staff will not be required to obtain health insurance through the Exchanges. This is simply untrue. The ACA requires individuals to obtain health insurance or pay a fine; this requirement indeed applies to Members of Congress and to congressional staff. Beginning January 1, 2014, my health insurance will come from the same Exchange my constituents will use. The recent action Mr. Lindstrom cites is simply the Administration’s clarification that the employer premium contribution I currently receive will be permitted to continue when I enter the Exchange. This is not a “subsidy” but rather a continuation of a health insurance benefit common to many Americans with employer-sponsored insurance. Finally, I note that my staff will not be eligible for subsidies or tax credits to help them purchase insurance in the Exchange. 

I am enthusiastic about participating in the Washington Exchange, and I anticipate a positive experience for myself and for my constituents. Washington State has been at the forefront of the Exchange development process, and I am confident this hard work will result in a well-run and very successful Exchange. With so many uninsured Americans threatened every day by bankruptcy from an accident or diagnosis, I am excited to see Washington State and our nation move closer to an effective health care system that serves all. I urge everyone to become informed about the ACA, to explore the great changes coming, and to spread the word. Valuable information about the ACA is available at HealthCare.Gov.

Sincerely, 

Congressman Jim McDermott

Washington's 7th Congressional District