SUMMARY: Texas has a great new price transparency database, but Washington’s legislature just rejected a plan to make transparency the law. The objections came from Washington’s biggest insurance company, according to a local press report.



We wrote recently about the new Texas database, and the state law mandating its creation. But recent attempts to create a database of prices in Washington state were ended — apparently because of lobbying by the state’s biggest health insurance company, Premera Blue Cross, according to a report in The Spokesman-Review last week.

“Lobbying behind closed doors, Washington’s largest health insurance company persuaded Republicans in the state Senate to gut a widely supported bill that aimed to reveal health care price and quality information to consumers,” said the article by John Webster, Premera Blue Cross’ lobbying leads to dropped health database requirement.

“The battle pits Premera Blue Cross against a broad coalition representing just about everyone who buys, uses, provides or shapes health care: small and large businesses, consumer advocates, tribes, hospitals, doctors, nurses, the governor, the insurance commissioner, the agency that governs insurance for state employees and the poor, and even Premera’s competitors. …

“The battle focuses on House Bill 2572, which passed the state House of Representatives and came up for a hearing Thursday in the Senate Health Care Committee. After some fiery testimony, committee Chairwoman Randi Becker, R-Eatonville, stripped the bill’s most controversial section and passed it on to the Ways and Means Committee for further action. She did so without explanation. A lobbyist for Premera stepped to the microphone and thanked her, but said little about the reasons for his gratitude.

“The controversy involves the original bill’s provision to create an ‘all payer claims database.’ Loaded with statewide health insurance claims, the database would allow people to compare what health care actually costs and how well it turns out – procedure by procedure, hospital by hospital. It would answer questions like these: What would a knee replacement or childbirth cost, and who does it best?…

“Contacted by The Spokesman-Review, Premera spokesman Eric Earling explained the company’s point of view: ‘We support transparency. We’d like to see more of it.’ But, he said, price information is not ‘actionable’ for a particular consumer unless it is presented together with information about the consumer’s own coverage details such as deductibles and co-pays.

“In addition, it would be ‘complicated, potentially expensive and time consuming’ to create a claims database and comply with its data submission requirements, he said. Meanwhile, he said, his company is busy trying to comply with existing requirements of the federal Affordable Care Act. Finally, Earling said, the rates Premera has agreed to pay to its networks of health care providers are ‘proprietary.’ If providers such as hospitals could see the full range of reimbursement rates, Earling said, they might use the information to demand higher payments, ultimately driving health care costs up instead of down. So, he said, Premera is working to show the cost of care only to its own customers.”

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...