Later this month, state legislators will begin discussions about designing and implementing a health-care exchange. If experience is a guide — and it is — Washington lawmakers should tread very carefully because recent events have shown how perilous such efforts can be.
State health-care exchanges, authorized under the federal health-reform law, were originally characterized as virtual open-air markets where health-insurance providers would compete side-by-side so consumers could easily compare coverage and cost. Some states are using the exchanges to introduce single-payer systems, squeezing out private insurers and dramatically increasing costs for consumers.
Will that happen here in Washington? Hopefully not. But the outlook is not promising. For example, the legislation creating our state health exchange was quickly approved and signed into law even though lawmakers had no idea what it will cost, where the money will come from, what it will look like or who it will serve.
Those details were left unanswered in the rush to get the bill approved. Cynics might wonder if the goal was to quickly pass the legislation three years ahead of schedule, before those tough questions could derail the effort.
Supporters say the state has $23 million in federal funding to implement the state health-insurance exchange — but that’s just for the first year. Where will the money come from next year? Nobody knows. These days, federal funding is not guaranteed.