Insurers for individual health plans shut out Grays Harbor

If you are one of the thousands in Grays Harbor County who rely on individual health insurance, you’re likely worried by Insurance Commissioner Mike Kreidler’s announcement Thursday that as of the June 7 deadline not one insurance provider had signed up to offer that kind of insurance in the county for 2018. Monica Ewing, a health insurance expert at Durney Insurance in Hoquiam says that worry is legitimate.

“They kind of do have a pretty legitimate reason to worry,” she said. “Nothing will change immediately, but come January 1 of 2018, as things stand, there will be no insurance carriers for individual policies in Grays Harbor County.”

Those who are part of group insurance plans through their employers, or who pay for Medicare supplemental plans, aren’t affected.

Of the state’s 39 counties, only two — Grays Harbor and Klickitat — failed to attract even one provider for individual insurance.

Which begs the question, why us?

“I suspect the problem with Grays Harbor County has little to do with politics and much more to do with our local health rankings,” said a local physician who preferred not to be identified. “We lag well behind most counties in the state in health parameters — from obesity to smoking to health care access — making the county a poor ‘bet’ for insurers. It always comes down to a financial bottom line, even for insurers on the Exchange, and obviously they want to game the system such that they’re not going to lose money.”

Kreidler’s office said that in 2017, 2,227 people in Grays Harbor were enrolled in the individual market.

Ewing believes the number could be higher: “I think that might be just those inside the Washington State Healthcare Exchange. I don’t know if it takes into account the number of people who work directly with other carriers, because if you don’t qualify for the tax benefit through the exchange, there is no reason to go through it.”

Stephanie Marquis, a spokeswoman for the Insurance Commissioner’s Office, said the commissioner and other elected officials are working to find ways to get at least one carrier back into the county in 2018.

“I would like to stress this is not a done deal, and the commissioner is working very hard to see if he can get one or more providers to reconsider coming into those counties,” said Marquis. “We have until the end of the summer and even up into fall to get somebody on board.”

Ewing is also hopeful the efforts of Kreidler, Gov. Jay Inslee and Congressman Derek Kilmer will also pay off before anyone has to lose coverage.

“I very much hope so,” said Ewing. “I know they’re going to put pressure on providers to see if someone steps up to the plate. This would be unprecedented. Most of the people involved wouldn’t be able to afford insurance without the tax-credit help. That would leave people to choose to eat or choose health insurance.”

Under current state law, if no health insurer is available in a particular county, the only coverage option is through Washington state’s high-risk pool, referred to by the acronym WSHIP. However, because this program is not a qualified Exchange insurer, subsidies would not be available, meaning high premiums.

Marquis noted the process for signing up for the high-risk pool is similar to signing up for insurance through the state. “But you don’t go through the Exchange, and the plan doesn’t qualify for subsidies so it’s generally much more expensive.”

WSHIP premiums are based on age, depend on the deductible you choose and also vary from region to region. According to the WSHIP website, in Grays Harbor County the basic plan monthly premium for a nonsmoker aged 20 and younger, with a $1,500 deductible, would be $719. For an individual age 65 and older, that premium skyrockets o $3,398. For a 35-year old person, nonsmoker, the basic plan monthly premium would cost $1,384.