When Pam Adam, 58, retired from a 40-year nursing career in 2015, she and her husband John were too young to qualify for Medicare. The couple, who live on a ranch in White Salmon, Washington, found an affordable health insurance plan through the state marketplace. That helped ease the cost of two major surgeries Pam had on her neck and ankle.
“We have a plan through the Affordable Care Act that helps us afford comprehensive care,” said Pam Adam. She and John pay about $250 a month for a silver plan with Lifewise, a subsidiary of Premera, the only insurance carrier left in Klickitat County.
But that could soon change. Originally two counties — Klickitat and Grays Harbor — had no plans offered by health insurers next year. But insurance Commissioner Mike Kreidler announced Monday afternoon that after he reached out to various insurance companies, Premera Blue Cross decided to offer two individual health plans to consumers in Grays Harbor County. Klickitat County remains without any health insurance providers for individuals purchasing plans through the state exchange.
“I felt a lot of anxiety, just overwhelmed really,” said Pam Adam, on the news that the only insurance provider had pulled out of Klickitat County for 2018. “And the thought if something big came up for me or John, what would we do?”
Residents in southwest Washington have a lot to lose, says Washington State Insurance Commissioner Mike Kreidler.
“If you have to pay and buy your own health insurance as an individual, and you want insurance, you better move to another county,” said Kreidler. “That’s what this decision means.”
“The principle problem is the Trump administration and Republicans in Congress beating the drum about repealing the Affordable Care Act,” said Kreidler, referring to the GOP-controlled Congress and its plan to repeal and replace Obamacare.
“That has had a seriously destabilizing impact on health insurance and does not reassure providers,” he said.
Premera says that’s not the case and argues the move is fueled by cost, not politics.
“Our decision to no longer offer individual health coverage in certain counties will help us keep cost increases lower for customers in other counties,” said Premera spokeswoman Melanie Coon in an emailed statement. “We believe approval of these rates will allow us to continue to serve customers in more counties than any other carrier on the Exchange and help us achieve our goal of serving our individual market customers for many years to come.”
Hundreds of people will likely lose coverage as a result, though — 1,119 people in Klickitat County. Kreidler said he’s discussing options with insurance providers and could have an announcement soon on a temporary fix. He has until the end of August to finalize coverage plans for 2018.
“This could really hurt our community,” said Karleen Swarztrauber, a neurologist and pain management doctor at Skyline Hospital in White Salmon, Washington.
Swarztrauber called the situation unusual but not entirely surprising. Rural communities have always been harder to serve, even under the Affordable Care Act. She says the population in Klickitat County tends to be low-income and has a high percentage of individuals on disability, about 20 percent.
“That’s pretty high,” Swarztrauber said. “It may point to why insurance companies have pulled out of this market. The number of sick people may have made costs too high for them.”
“When people hear we don’t have insurance, small business owners may choose to move somewhere else,” she said.
That’s something Michelle Nijhuis and her family are considering. She is a freelance science writer and journalist and her husband, Jack Perrin, is a science and technology teacher who runs a maker space in White Salmon. They’re both self-employed and have always been responsible for their own health care.
“I really hope it doesn’t come to that, but it’s something we’re talking about,” said Nijhuis, on whether her family would have to move to another county with better health care options.
“The future is very cloudy right now.”