At a news conference on Thursday across the street from the University of Washington Medical Center, the Republican candidate for governor also said he expects to negotiate with the federal government to give the state more flexibility on Medicaid.
McKenna said he doesn't want to push anyone off the free or low-cost health insurance for those who can't afford private insurance, but he also doesn't want to make Medicaid so attractive that some people who have insurance through work will switch the Medicaid if they are eligible.
He said he thinks there are ways to help save money for the federal government, the state and private employers, if the federal government is willing to negotiate with the state. He also suggested Washington start charging a Medicaid co-pay in the range of $5 like some other states.
An attractive private insurance exchange combined with employer incentives from state government could help keep some people from switching to Medicaid from private insurance, he believes. But McKenna he wants some help from the federal government to make this happen, possibly in the form of flexibility on other parts of the Affordable Care Act, the federal health care reform.
"They'll want to negotiate with us because they want it to be successful," he said.
McKenna, who was one of the attorneys general who sued the federal government over health care reform, says he's most interested in federal government flexibility concerning the individual mandate of the Affordable Care Act.
It's time to address the problems in the Affordable Care Act and move on, McKenna said, when asked if he agreed with Republican Presidential Candidate Mitt Romney's call to get rid of the act entirely.
Former Congressman Jay Inslee, who is the Democratic candidate for governor, believes the individual mandate of the Affordable Care Act is one of the tools the government is already using to lower the cost of insurance for everybody, said his spokesman Sterling Clifford.
In Inslee's own plan for health care, of which he gave advance copy to The Associated Press, he points out that the federal government's plan to make more people eligible for Medicaid will actually save the state money because their entire premiums will be paid by the U.S. government.
He also wants to give incentives for improving health and management of chronic illness. He used the state's stop smoking program as an example of the way Washington could decrease health costs for other problems. Inslee would help consumers find the best insurance through the state's new insurance exchange by publically grading health plans.
Clifford dismissed McKenna's idea of negotiating with the federal government over Medicaid.
"It's unfortunate that having lost one confrontation with the federal government over health care, Rob McKenna has made seeking a second confrontation the centerpiece of what he would do as governor," Clifford said. "Washington needs a governor who will move forward rather than pursue old grudges."
McKenna had a number of other ideas for reducing health care costs in Washington state overall, and agrees with Inslee about rewarding people for making healthy choices.
He would like to raise some insurance premiums for state employees to encourage them to choose the health insurance options that cost the state less money. He wants to pay doctors for improving outcomes and reducing chronic illnesses and avoiding unnecessary tests and procedures.
His biggest potential target is state employee health insurance, which now eclipses higher education in the state budget.
McKenna would like to lower premiums, raise co-pays and put money into individual health savings accounts. He would give discounts for wellness activities and not smoking. If they didn't use their health savings account, they could take the money with them when they retire. He modeled the idea after a similar program in Indiana.
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