One of the most contentious and controversial issues I can remember in recent legislative history is coming up to be heard in House commerce committee tomorrow – House Bill 1067, a measure which is designed to turn back the vote held in 2014, which was commonly known as the patient choice measure or Initiated Measure 17.
Why is this measure being brought back to be fought over? As noted in an article on KELOland TV yesterday:
Peters says it was her own personal experience paying for health insurance, because she’s self-employed, that led her to co-author a new bill to amend the measure.
“For consumers of health insurance plans, we only get one choice. You have to buy all panel of providers–that then drives up the cost of your insurance plan,” Peters said.
And…
It’s a change that Sanford Health is lobbying for, while physician-owned facilities like the Sioux Falls Specialty Hospital, whose CEO is state legislator Blake Curd, is against.
And…
But changing a law that was overwhelmingly voted into place can be a challenge for those also voted into office.
As I’ve noted before, this former ballot measure passed by the widest margin of any ballot measure voted on in 2014. Making it extremely hard to argue that somehow the will of the voters was misconstrued.
If voters didn’t know what they were doing to themselves, why did they do it in such incredible numbers? I’d argue that a lack of knowledge wasn’t really the case. They went into it with eyes wide open.
One of the things people were slapped in the face with in 2013/2014 was a president who told them distinctly and absolutely that under the president’s health care plan, Obamacare, “if you like your doctor, you can keep your doctor.” As he noted in 2013…
But then, just a few months later, in a sit down interview, the president was forced to admit that his prior statement wasn’t exactly correct…
“For someone who didn’t have health insurance previously, they’re going to have to make some choices. And they might end up having to switch doctors in part because they’re saving money.”
The electorate didn’t like it when Obama told them they couldn’t keep their doctor anymore. They really didn’t like it. And, that may have contributed to Initiated Measure17’s success at the ballot box.
But fast-forward 18 months later, and we’re now fighting this battle all over again.
House Bill 1067 has really come down to a battle of wills. On one side, we have the electorate who spoke with an overwhelming voice, and said people would be allowed to use and keep their doctor. Are there consequences? I don’t doubt there are, but can the added costs really be as high as the proponents claim, since the Doctors are required to accept the in-network rate?
Maybe. But, if that’s what the electorate voted to accept, voted as being what they wanted, that’s what they voted for.
IM 17, for better or worse, was the will of the electorate, and an example of prairie populism fully expressed.
House Bill 1067 has the will of the electorate butting up against the will of the Sanford Health Systems who has been aggressively pursuing the measure, as they have lined up an army of lobbyists, and an army of employees e-mailing legislators. (Although, the employees might not exactly be mentioning who they work for when they send those e-mails.)
Avera has kept a low profile on this, which is interesting, as it brings into question the systemic problems that the measure’s proponent’s claim. They have health plans too – so why aren’t they in the mix?
Clearly, House Bill 1067 is the will of the Sanford Health System, who wants to tell people that if they want to keep their doctor, they want to charge them more. Or what was the point made earlier..? I believe the direct quote was “they might end up having to switch doctors in part because they’re saving money.”
Not exactly a point for Republican lawmakers in South Dakota to campaign on.
If the measure is overturned in Pierre, it’s not like this fight is going to end in the legislature. I’ve already heard that if House Bill 1067 passes, petitions will be circulated to place it on the ballot as a referred measure. So, not only could this fight go on, it could drag on to November.
But for now, the will of the people and the will of Sanford are set to clash tomorrow in committee. Time to grab some popcorn and to watch the fireworks.
Knowing co-sponsors have publicly stated they were not informed of the final ramifications of an enacted HB 1067 leads me to believe it dies in committee. As it dang well should.
Charlie is right. The people have already spoken on this and it is insulting that Sanford is trying to change the law.
Sanford is opposed to physicians owning or controlling healthcare services and leads a nation coalition against physician ownership. I have never understood the concept that somehow it was inherently bad for physicians to own hospitals but not bad that hospitals employee physicians & own insurance companies. They mandate their employees do the same thing they accuse independent physician of. The AWP initiative was an public rebuke of Sanford’s position. Rather than have a transparent public debate on how society can realistically control rising health insurance costs they choose to use less than accurate & disingenuous information to manipulate the political system in their favor. Shame on Sanford for not respecting the customers they service or the system that gives them tax-exempt status..
Deb Peters is a train wreck. She does not treat anyone with respect.
Curd knows his stuff. He’s a class act.
Be nice. This isn’t about legislator personalities, and Deb certainly isn’t a train wreck.
Curd fought hard against Obamacare. That says it all for me.
Deb Peters should get her facts straight. As a consumer I do not have to buy an all inclusive plan. The payer can still market a narrow network – it only becomes more inclusive when they reach acceptable terms with a provider who would otherwise be out of network.
The people have spoken. I am insulted that Sanford doesn’t think I understood what I was voting for!
Don’t be upset with Sanford. Peters is the one pushing this. She will tune you out. She doesn’t listen.
I believe the problem was caused by the federal exchange listing the Avera plan as if it applied to the entire state. It was the cheapest of the plans offered and people signed up for it, not realizing it was only good at Avera facilities, in the eastern half. Instead of blaming themselves for their mistake, they blamed the insurance company.
Fact is, they could have kept their doctor and their hospital, but they needed to buy the correct insurance policy.
So because a few people signed up for the wrong plan, through nobody’s fault but their own, we got IM 17.
When I first was elected to the Legislature in 2004, I thought all issues were black and white. Yes, the right side and the wrong side. After attending my first few Committee meetings, I quickly learned that there are at least 2 sides to every issue. There is grey. Just pick a contentious issue and listen to a Committee hearing on the LRC website, and you will see what I am talking about.
Enter IM17. The vote in 2014 was not the first time Any Willing Provider was discussed in our State. The Legislature had debated Any Willing Provider at least 3 times in recent history, the last in 2013 when it was defeated in the Senate. On one side, you have the providers who maintain that South Dakotans’ should be able to choose any Doctor they want if the Doctor will accept the payment scale offered to closed plan Doctors. On the other side, you have the insurance companies who maintain that by offering a closed plan with certain Doctors who have accepted a discounted payment plan in return for treating all the patients in the plan, and have signed a contract with the plan, they could reduce the premiums for the consumers in the plan. To their credit, the providers had a great sound bite, “choose your Doctor”. And they had great commercials – we all remember the kids and the puppies! The insurance industry sound bite was, “we can save you money on your premiums”. It just wasn’t sexy or effective, and IM17 won by over 60%.
So why HB 1067? The answer is, the insurance industry still believes there is a market among South Dakota consumers who want a lower premium. HB 1067 does NOT repeal IM17. Rather, it keeps IM17 intact requiring insurance companies to offer an open plan so that South Dakotan’s who want to choose any Doctor will have that option. Then, it says, that if the company offers that open plan, they can also offer a closed plan. So, HB 1067 is about choice. If South Dakotan’s want to choose their Doctor, they can choose the open plan. If they are more concerned about premium than which Doctor they go to, they can opt for the closed plan. It’s their choice. And isn’t choice what IM17 was all about?
Two more things you need to know about HB 1067. #1. This law only applies to South Dakotan’s insured under an individual plan or a Small Group plan with 2 – 49 lives. If you are insured under a Large Group plan, (50 + lives) or an ACA plan, or Medicare, or Medicaid, etc., HB 1067 does NOT apply to you. These plans are regulated under Federal law, and are NOT subject to state regulation. #2. There are only 4 companies licensed in South Dakota to sell plans with 2 – 49 lives. Only 4, that’s it. Avera, Sanford, Dakota Care, and Wellmark.
HB 1067 is good public policy. It should have a fair hearing. We should let South Dakotans have a choice.
Rep Mark Willadsen
District 11
Sioux Falls
Mr. Willadsen,
By voting in overwhelming fashion for IM 17, SD voters expressed a strong desire for choice of DOCTOR who might be willing to accept terms and conditions of payment for medical services rendered from an insurance company. Period. Not for choice of insurance plan … as you insinuate in your diatribe.
Yes, all are aware that there are only 4 companies licensed as choices for health insurance consumers in SD (actually three, due to acquisition of DakotaCare by Avera). It is this way not only because of the sparse population of this state, but even more so because of licensing requirements placed by state insurance commissions, on a state-by-state basis, upon those companies who might choose to underwrite policies in respective states. This legislation places additional requirement on a company wishing to write health insurance policies in SD. Rather, we need to remove regulatory barriers to engage more companies to write policies in SD.
Not surprising that an insurance agent can twist words like you have in your … err… Sanford Health’s representation of this legislation. I bet you are something to behold in the arena of representing the outstanding investment opportunity available for prospective policy-holders from whole life insurance policies.
A couple of the co-sponsors of this legislation have done well to move Insurance Salespeople down the ‘trust’ scale toward the lowly standing of Used Car Salesperson (or Health System Executive !).