LAST WEEK, a group of seriously ill and disabled people faced down Washington state's powerful business lobby over health insurance premiums—and won.
The Washington State Health Insurance Pool (WSHIP) is the state-run plan that offers health insurance for sick people who have been denied coverage elsewhere. Last Thursday, the WSHIP board met at the downtown Sheraton and voted unanimously not to increase monthly premiums by the maximum amount allowed by law. Instead, members opted for a lesser increase that, subject to legal approval, would be phased in over three years.
It was a rare and perhaps quixotic victory in a health care climate that has little good news for sick and disabled people, who, paradoxically, are most in need of health insurance but are also the most likely to be denied it.
The Thursday meeting was a textbook case of effective lobbying on the part of health care activists. The most compelling testimony was presented by several people who depend on this insurance for their very lives—including Edmonds resident Jill Cannon. Nine years ago, Jill's autonomic nervous system began to fail, precluding her from eating or drinking except through an intravenous tube. She goes through one $280 bag of fluid per day, which is covered only under the WSHIP plan.
"Without this plan, Jill would die," her husband, Clark Cannon, told the board, his voice choked with emotion as Jill leaned against the wall of the conference room. Simply attending the three-hour meeting would be enough to send the former nurse back to bed for the next two days. "I want to put a face on that for you."
Board members weighed the plight of people who have immune system diseases like AIDS or suffer from the complications associated with organ transplants against pleas by representatives from the business lobby.
Mel Sorensen, a lobbyist representing a coalition of state business organizations, protests that it isn't fair to pass on costs to mostly small-business owners who are "trying to do the right thing and insure their employees."
Everyone concedes that Sorensen has a point. The actual medical expenses of very ill people are not fully covered by the insurance premiums they pay under the WSHIP plan. Insurance companies pass those extra costs along to businesses and individuals who buy insurance in the form of higher rates.
Spreading the costs over the 3.2 million people who get insurance through group and individual coverage, however, makes the rate increases comparatively small: Monthly bills will rise roughly 3 cents per person in order to pay for very sick people's costs, according to a state actuarial report.
"Pennies here, pennies there—they all add up," said Glenn Hudson, a representative with the Association for Washington Business.
But Barbara Flye, executive director of Washington Citizen Action, a health care advocacy group, laid three pennies on the table during her testimony.
"I'll be glad to pay my three pennies, here is the first installment," she said. "The decision you make today is truly a life or death situation for these people."
Sean Corry, an insurance broker and WSHIP vice chair, led the charge to approve the smaller, graduated rate increase. "I'm proud of the board," Corry declares. "They did the right thing, in the face of pressure from the business lobby." That "right thing" was by no means a sure thing, he adds. "I had no idea how the other members were going to vote, and it wasn't looking good from the consumer advocacy standpoint," Corry says.
"This is a small victory in a health care environment that is very dysfunctional," he notes ruefully. "Perversely, the health insurance industry is not well suited for taking care of sick people."
Even with this victory, premiums will still rise for the nearly 900 very ill people covered in the WSHIP plan—they just won't rise as high or as quickly. The Cannons, for instance, say they'll still feel a financial strain. They now pay $99 per month on the WSHIP plan and will see their rates increase to $240 per month. That's better than the $500-$600 per month alternative pushed by the business lobby, but it's still a hit.
"At least Jill has me: I'm working and can bring in money to support her," Clark Cannon said. "For the disabled people who don't have family—that's it. They won't even be able to afford this rate increase."