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Washington state to prevent Obamacare from narrowing health networks


Washington state plans to approve a new rule this week to limit insurers’ ability to create narrow networks as a means of cutting costs, thanks to backlash over the limited health plans available in the wake of Obamacare regulations.

In response to the outcry over narrow networks, Washington state’s insurance commissioner Mike Kriedler wants to limit insurers’ ability to narrow their networks, potentially making rising premiums one of the only means of recourse that insurers have left.

“Both qualified health plans and health plans offered outside of the Exchange must have networks that at a minimum ensure access to covered services without unreasonable delay and address the specific needs of the populations served,” reads a proposed rule from the office of the insurance commissioner.

“We want to make sure that if you’ve made the promise that you can get this care, that there’s going to be a delivery on these services,” Kriedler told the exchange board, according to local Seattle station KPLU. Kriedler is expected to approve the rules by April 23.

As health care costs have risen over the past decade, narrow networks have slowly been growing in popularity, but the influx of regulations on health care plans with Obamacare stoked the fire. But the public has largely panned the narrow networks, particularly after the president’s promise that Americans would be able to keep their doctor.

Advanced care cancer hospitals, for example, are left out of most exchange plans across the country. (RELATED: Obamacare exchanges not covering best hospitals for cancer care) In Washington state, the Seattle Children’s Hospital, the top center to treat children’s serious diseases, is even suing the state exchange because it is left out of a majority of the health plans offered on the exchange.

But narrow networks are one of the few ways that insurers are able to limit their costs under new Obamacare regulations that require all health care plans, on and off the exchanges, to provide a large swath of services to everyone, some even at no cost to the customer.

The other option available to insurance companies is simply to hike their premiums. Kriedler reportedly doesn’t believe prices will increase as a result of his rule.

A representative of the Association of Washington Healthcare Plans hit back against Kriedler’s proposal at a recent board meeting.

“The sheer weight and volume of the administrative and reporting requirements that come along with that have the effect of just smothering the ability to provide more innovative networks.”

It’s not yet clear how the state will enforce its limits on narrowing networks or what the benchmarks will be. The proposed rule concedes that further clarification of “provider network criteria” is still needed, but Kriedler believes customers “shouldn’t have to drive too far or wait too long for care,” KPLU reports.

Kriedler is expected to approve the rule this week, following a public hearing Tuesday morning; but the insurance commissioner’s office believes that the proposed rule is unlikely to change before it is approved.

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