There are different ways to tell the story of what’s happening with Washington’s insurance exchange, a state marketplace called the Healthplanfinder, through which some one million people signed up for coverage (including more than 800,000 for Medicaid). You can write a glowing, puffy profile of the state’s insurance commissioner, as Seattle Times health writer Carol M. Ostrom did earlier this month (“Longtime leader Mike Kreidler plunges into political storms”), telling readers the commissioner puts Tabasco sauce on his lunch every day. Or, you can write day after day about alleged misconduct in that commissioner’s office, providing readers with a rare glimpse of how state government works, with all its conflicts of interest. Now, the Seattle Times hasn’t ignored this story (Ostrom didn’t reply to an email request to talk about the Times’ coverage), but Valerie Bauman, a health reporter for the Puget Sound Business Journal, has made this convoluted saga comprehensible, offering readers dogged and thorough coverage of this fascinating and far-reaching tale. It is a tale that spins out of a lawsuit brought against the commissioner’s office last year by Seattle Children’s Hospital alleging “failure to ensure adequate network coverage” (several insurance carriers had omitted Children’s from their networks because of its high prices). The whole affair touches on the struggle to control heathcare costs, narrow provider networks for consumers, and efforts to protect the financial turf of the insurance game’s biggest stakeholders. For her work, Bauman deserves a CJR laurel.
News outlets, let alone business journals with small circulations, rarely dig into the administrative hearings and rule making procedures where state agencies write the regulations essential for implementing legislation. It’s where the action is, but journos avoid such things (too boring, too tedious, too hard to understand). But since mid-May, when the insurance commission’s own administrative law judge, Patricia Petersen–who adjudicated disputes between the commission and regulated insurance carriers–filed a whistleblower complaint alleging that Kreidler’s deputy inappropriately tried to influence the outcome of her decisions and threatened her job if she didn’t decide the case in favor of Kreidler, Bauman has produced 24 stories following nearly every twist and turn. And there have been many of them–including a mysterious “Office Depot tipster”. In other words, Bauman has had drama on her side, along with the support of the Journal, and a lot of luck. “There were a lot of deep throats giving a tremendous level of detail,” she said. “I was getting leaked documents faster than I can get the story out.”
Recently, Bauman snagged Kreidler for a quick interview during which he stood by his deputy, telling Bauman he didn’t believe Petersen’s accusations. In a “turnabout,” as Bauman put it, Kreidler’s office is now investigating Petersen. The whole messy saga raises questions about the independence of administrative law judges and has sparked calls for reform in Olympia.
As for the Seattle Children’s case, one insurer still involved in the case has filed a motion to throw out Petersen’s rulings, meaning the case will probably start over. It’s also possible the two carriers reamaining in the suit will strike a deal with Children’s, as other insurers have done, ending the challenge to the insurance commissioner. At that point, the story would twist into a different one. What compromises did the carriers make, and how will that impact insurance premiums? After all, it’s the premiums that matter to the people of Washington.
Bauman told me the Petersen saga has been a winner for her publication, pulling in high traffic numbers on the Journal‘s website. The Journal‘s readers are interested in making sure government is accountable and gives businesses a fair shake, she told me. But they are also interested in how we come to define narrow networks–which is, in the end, what this “whisleblower judge flap,” as one of Bauman’s headlines shorthanded this, is all about. “Both are tremendously important,” Bauman said. We agree and hope she stays on the case.
Related content:
Exchange Watch: Washington state
Exchange Watch: Missing doctors, missing coverage
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.