Opinion: OIC tells consumers not to pay for ‘insurance’ you won’t likely benefit from: Does that include WA Cares?

Elizabeth New (Hovde) of the Washington Policy Center believes you should consider yourself warned by the Office of the Insurance Commissioner about WA Cares and its maybe-only benefit.

Elizabeth New (Hovde) believes you should consider yourself warned by the Office of the Insurance Commissioner about WA Cares and its maybe-only benefit

Elizabeth New (Hovde)
Washington Policy Center

I listen to a podcast called “OIC Answers on Insurance.” It’s published by the Washington state Office of the Insurance Commissioner to help people better understand how insurance products work. On July 1, I was amused that the state’s insurance agency made a quality case against being a part of the state-mandated WA Cares program, likely without knowing it.

The hosts of the show were talking to OIC Deputy Commissioner Michael Marchand about Health Care Sharing Ministries (HCMSs). He cautioned people against joining them and told listeners about how the OIC works to prevent them from operating in our state.

What are Health Care Sharing Ministries (HCMSs)? The OIC guys stressed they are not insurance. They are pools of voluntary payers who contribute money to a fund meant to help people pay for health care costs as needed but with no guarantee.

The Kaiser Family Foundation reported on a study that found at least 1.7 million Americans relied on health-sharing arrangements, and Healthinsurance.org says many people have been attracted to them since the Affordable Care Act. Monthly participation dues tend to be lower than full-price health insurance premiums for people who don’t qualify for taxpayer-provided subsidies through the ACA. These cost-sharing funds, however, often disappoint participants with lack of, or hard to get, reimbursements. If it sounds too good to be true, it probably is, said the OIC.

Sounds similar to the setup for WA Cares to me, only Washington workers are forced to pay into WA Cares, they don’t contribute voluntarily to the cost-sharing fund, which is being passed off by the state as insurance. Even the payroll tax is called a premium by supportive lawmakers and state agencies.

Most workers pay a payroll tax of 58 cents on every $100 of earnings for WA Cares. Like with HCSMs, those paying into WA Cares month after month, year after year, might never see any of their money again or be able to use WA Cares dollars, even if they need long-term care.

Still, state agencies have been busy marketing WA Cares as a fund that should give you peace of mind about your possible need for long-term care. It shouldn’t. The state is still working out the details for what qualifies for payments with WA Cares and has already determined that people paying in can’t become beneficiaries unless they pay the payroll tax for 10 or more years without a break of five or more years. Even if you do qualify for a WA Cares benefit one day, the amount typically will not be enough to handle most people’s long-term-care needs. The fund also has solvency concerns.

Peace of mind with WA Cares is not wise. Planning for possible long-term care, as people need to do with other life needs, such as shelter and food, is.

Some favorite moments from OIC that apply to WA Cares but were said about HCSMs?

— “The problem is they look and feel and act like insurance, but they’re not actually insurance. This confuses consumers and many people get left out in the cold ….”

— While explaining to listeners how many people sign up for these cost-sharing pools and are shocked when they receive nothing in return, the OIC representative said, “It’s heartbreaking because they paid in for months and months and months, essentially what is a premium or a monthly payment, and they get no benefit from it. … make sure you don’t buy into something that ultimately, at the end of the day, won’t provide you with anything.”

— In closing, Marchand said, “Your health is way too big of a decision to make to leave it in the hands of an organization that probably won’t pay you for anything you’re giving them.”

Consider yourself warned by the Office of the Insurance Commissioner about WA Cares and its maybe-only benefit.

Elizabeth New (Hovde) is a policy analyst and the director of the Centers for Health Care and Worker Rights at the Washington Policy Center. She is a Clark County resident.