Letter to the Editor: Congressman McDermott responds

Friday, August 16, 2013

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.


Congressman Jim McDermott
Washington's 7th Congressional District


Anonymous,  August 17, 2013 at 7:35 AM  

It's great that individuals will be required to buy insurance or pay a fine. Now, like Justice Clarence Thomas and other leading conservatives, people will be asked to "pull themselves up with their bootstraps" and stop expecting others to take care of them.

moderator August 17, 2013 at 9:29 AM  

Thank you Congressman Jim McDermot for your clarifications of this so often obfuscorated matter.

Anonymous,  August 17, 2013 at 10:44 AM  

Thank you Congressman McDermott for clearing up the rumors that are being spread against the Affordable Care Act.

Jeff Lindstrom,  November 12, 2013 at 11:39 PM  

Unfortunately, Mr. McDermott's response did not address the key concerns that I had. Now that the Exchange is open, we see that the errors in his letter which I highlighted are coming to light.

1. All non-grandfathered Individual Health Plans ARE going away December 31st. These Policy Holders cannot "keep the plan you have" as he stated. To say that the plans "may change their offerings" is untrue, they MUST change, you cannot "keep the plan you have."

2. There are no "Platinum" plans offered in the Washington Exchange as evidenced by looking at the plans now available. He refuses to address this often stated error.

3. "Wellness" programs do not provide the same level of rate reductions as the current business plans through Associations, Trusts, and Unions currently do. Mr. McDermott dodges that question and instead brings up an different subject matter to deflect the true concern raised.

This law is a good start, but trying to defend it with blatant untruths does not help Mr. McDermott's cause.

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