Insurance chief defends rejecting 5 insurers from Washington exchange

Washington Insurance Commissioner Mike Kreidler has publicly described the reasons behind his decision to deny five insurers from selling their proposed health plans on the state's health insurance exchange.

Although Washington's insurance department approved 31 plans that will be provided by four insurers, it "unfortunately" also had to reject some applications. "These were not decisions I made lightly," Kreidler wrote last week in an open letter. "I am a strong supporter of competition and consumer choice, and a longtime supporter of healthcare reform."

He explained that "substantial problems in the plans" led him to reject the five insurers' applications. For example, several of the plans lacked an adequate provider network, including one that didn't provide a pediatric hospital and another that didn't cover a retail pharmacy. Other denied plans didn't have adequate access to transplant surgeons or HIV/AIDS specialists, he added.

"It's our duty to make sure that if you buy a health plan, you can actually see the doctor or hospital that provides the service you need," Kreidler said in a previous statement announcing the 31 new health plans. "This was a challenge for some of the insurers new to the commercial market."

Kreidler's explanation was greeted with some criticism. The Seattle Times, for example, accused him in an editorial of not pushing back enough on the federal government, saying Kreidler should have demanded more time to improve the issues within the rejected plans. "These are problems that can be worked out," the newspaper wrote.

But Kreidler said he is remains "optimistic" about the future of the Washington exchange. "We will continue to work with all carriers to help them get ready for the next year, when I fully expect more insurers to succeed," he said. "We knew this first big year of health reform implementation would be a bumpy ride, and it has been."

To learn more:
- here's the Kreidler open letter and statement
- read the Seattle Times editorial

Suggested Articles

CMS finalized rates for Medicare Advantage and Part D plans for 2021, offering a 4% boost and an increase in ESRD payments.

Digital health venture funding was on a tear in early 2020, with a record $3.1 billion invested during the first quarter, according to Rock Health.

As the COVID-19 pandemic rolls on, providers are asking payers for one thing: cash.