Case Study 2

Washington State's 1993 Experiment with Health Insurance Reforms

In 1993, Washington adopted one of the most extensive health care reforms ever enacted by a state. The law promised the grail of near-universal coverage while controlling costs. But the law was not implemented as intended, and as Washington residents soon discovered, unless these types of reforms are paired with an effective personal coverage requirement, real problems emerge for employers, families and individuals.

In 2000, a higher percentage of residents was uninsured than before the 1993 reform act, and our state's three largest issuers in the market stopped writing new individual policies."

If you don't have a mandate, you have significantly fewer covered - those who are covered are older with more problems - and premiums will be significantly higher."

It will be much harder if there is no mandate... If that plays out, it would look exactly like Washington in the 1990's."