BILL REQ. #:  H-1146.1 

     AN ACT Relating to ensuring the viability of the individual market in light of federal health care reform; and creating new sections.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   (1) The legislature finds that:
     (a) The passage of federal health care reform will have a destabilizing effect on the individual health benefits market. Guaranteed issue, elimination of preexisting condition exclusions, low penalties for failure to comply with the individual mandate, and the closure of high-risk pools will result in higher premiums to individuals caused by adverse selection in the market. These higher premiums will make health benefits coverage prohibitively expensive both inside and outside the health benefits exchanges established pursuant to federal law, notwithstanding federal premium subsidies, and will lead to carriers being forced to cease providing coverage to individuals in this state.
     (b) The state of Washington has a great deal of experience in providing coverage for high-risk individuals, while also providing needed stability in the individual market, through its separate high-risk pool, the Washington state health insurance pool.
     (2) It is therefore the intent of the legislature to ensure stability and reasonable costs in the individual market both inside and outside the health benefits exchanges established pursuant to federal law, while also providing comparable coverage for high-risk individuals by:
     (a) Preserving the ability of health carriers to require certain high-risk individuals to purchase health benefits coverage through the Washington state health insurance pool; and
     (b) Preserving the ability of health carriers and the Washington state health insurance pool to impose benefit waiting periods for preexisting conditions.

NEW SECTION.  Sec. 2   (1) No later than January 1, 2012, the insurance commissioner shall submit a waiver request to the center for medicaid and medicare services. The waiver request shall preserve the state of Washington's ability to provide health benefits coverage to high-risk individuals through the Washington state health insurance pool after individuals are able to purchase individual health benefit plans through health benefit exchanges established pursuant the federal patient protection and affordable care act and the health care and education reconciliation act of 2010.
     (2) The waiver request must contain the following elements:
     (a) The state of Washington shall continue to operate the Washington state health insurance pool;
     (b) A health carrier shall continue to have the authority to require any person applying for an individual health benefit plan to complete the standard health questionnaire, regardless of whether the health carrier offers coverage through the health benefits exchange or through the market outside of the exchange;
     (c) The health carrier shall continue to have the authority to decide not to accept a person's application for enrollment in its individual health benefit plan if, based upon the results of the standard health questionnaire, the person qualifies for coverage under the Washington state health insurance pool;
     (d) Individuals enrolled in the Washington state health insurance pool shall receive the same federal premium subsidies they would have been eligible to receive in the health benefits exchange, if any; and
     (e) Both the health carrier offering health benefits coverage to individuals and the Washington state health insurance pool may continue to impose benefit waiting periods for preexisting health conditions as authorized under Title 48 RCW on the effective date of this section.