They Shoot Horses Don’t They?
Health panel slips down path of old health care commissions
By Barb Rea
ESPC health issues volunteer
Last week the Wyoming Health Benefits Exchange Task Force quietly voted to suspend its work until after the U.S. Supreme Court rules on the constitutionality of the Affordable Care Act (ACA). While this was meant to send a message to the legislature about the futility of the current decision-making process, it will surely look like a victory for those members of the legislature who are determined to shut down anything associated with reform of Wyoming’s healthcare system.
This is another loss for the healthcare consumers in Wyoming. They are now left with no one trying to guide this ship through the stormy sea. I say ‘another’ because this is the exact set of circumstances that ended each of the versions of the Wyoming Health Care Commission. Good people, volunteers, directed to come up with solutions to improve our healthcare system, come together to try to get their arms around a complicated topic. It takes a year or two to get up to speed, but if you try to keep it apolitical, the legislature feels left out and the committee has to back up and add legislators. If the insurers are left out, the committee has to start over with a new direction that must end with a new insurance product. I’m not sure how many Health Care Commission executive directors there were, but each left the position out of this same frustration.
Al Harris, a businessman from Green River and member of the task force, voiced his frustration early in the meeting last week. Two years ago, the task force was created by then-Governor Dave Freudenthal and clearly told to make a recommendation to the Joint Labor and Health and Social Services Committee about whether Wyoming should establish its own insurance exchange, partner with other states or default to the federal option. Then the next year, under new Governor Matt Mead, the task force was morphed into some sort of hybrid legislative committee adding more legislators and forcing them to reset while these new members came up to speed.
In the winter budget session, the task force merely asked the legislature for an extension to continue studying the issue with the grant money awarded under ACA. Instead, the legislature directed the task force to produce not one but three full-blown exchange options – one that complies with the ACA, one that clearly violates the ACA and one that allows for a partnership with the federal government.
Mr. Harris simply pointed out that the committee already decided that one of those options, building a non-compliant exchange, would ensure that we have two exchanges, one operated by the state and one by the feds, guaranteeing that both would fail. He pointed out that the task force did its best to keep the study apolitical. (And now the legislature is allowed to do whatever it wants, anyway.) I believe Mr. Harris thought he would be the only vote not to seek an extension of the funding the task force needed to continue its work, but each member of the committee fell like a domino, also expressing the same frustration, and the decision to stop working was made.
Clearly, Wyoming does not have the leadership or the expertise to craft our own solution to this problem. We have the evidence before us. We already know Wyoming’s leaders are willing to leave large groups of our population uninsured. Our Medicaid program offers nothing for low-income, childless adults.
We already know some Wyoming leaders are willing to settle for a cheesy product that is not insurance if we were to take over the Medicaid program and not accept a single dollar from the federal government. The Healthy Frontiers Program was not insurance and would surely have only added to the problem of cost-shifting and under-insurance that the ACA is designed to fix.
We already know Wyoming won’t step up to the plate and regulate insurance companies. The state turned down two offers of $1 million to our Department of Insurance to help our insurance commissioner conduct rate review requests at the state level. We are now out of compliance with the ACA which requires states to conduct rate review or allow the secretary of Health and Human Services to provide this oversight.
The ACA is forcing Wyoming and other foot-dragging states to set the bar higher: cover everyone with a comprehensive set of benefits and protect consumers from unfair and discriminatory insurance practices.
And, under the ACA, the federal government picks up (or more accurately, provides the mechanism for redistributing) the cost. The way the ACA is designed now, Wyoming would benefit from this redistribution more than most states with more of our own federal income tax dollars coming back into the state. (State Progress Toward Health Reform Implementation: Slower Moving States Have Much to Gain, Urban Institute, January 2012)
The current system leaves people out, is discriminatory and expensive. There is broad agreement that the solution must be a fundamental reform in the way we collect information about cost and quality and the way we pay for health care.
Wyoming continues to bury its head in the sand instead of appointing an apolitical health-care planning board and allowing it to guide this process in the best interest of state citizens. If the legislature must be involved, the voters should not elect another person who doesn’t value health care for all as an essential part of the infrastructure a state needs to do business.
People shouldn’t have to worry they will lose their healthcare if they get sick or change jobs. Insurance should work. It should pay for the care you need when you need it. Why do we put up with less?
If the ACA is struck down, we still have a broken system to fix. Why not use the tools at hand to begin this work AGAIN?