State Senator Patty Kuderer Seeks to Be Washington's Top Insurance Watchdog

Campaign Website - Patty Kuderer

[00:00:00] Crystal Fincher: Welcome to Hacks & Wonks. I'm Crystal Fincher, and I'm a political consultant and your host. On this show, we talk with policy wonks and political hacks to gather insight into local politics and policy in Washington state through the lens of those doing the work with behind-the-scenes perspectives on what's happening, why it's happening, and what you can do about it. Be sure to subscribe to the podcast to get the full versions of our Friday week-in-review show and our Tuesday topical show delivered to your podcast feed. If you like us, the most helpful thing you can do is leave a review wherever you listen to Hacks & Wonks. Full transcripts and resources referenced in the show are always available at officialhacksandwonks.com and in our episode notes.

Today we'll focus on the race for Insurance Commissioner, which plays a critical role in regulating insurance companies and protecting consumers in our state. The Insurance Commissioner oversees the insurance industry - making sure companies follow the rules, reviewing policy rates, and licensing agents and brokers. Additionally, the Insurance Commissioner handles consumer inquiries and complaints, advocating for residents who face challenges with their insurance providers. In this election, voters have the chance to shape the priorities of this important watchdog agency. Insurance impacts nearly every aspect of our lives, from health and auto insurance to homeowners and business policies. The Insurance Commissioner ensures that rates are fair and justified, coverage is comprehensive, and the market remains competitive and transparent. Whoever is elected Insurance Commissioner will also play a key part in the state's larger discussions around our approach to addressing climate change, universal health care coverage, reproductive care, privacy rights, and more. While the Legislature has the responsibility to legislate these statewide issues, the Insurance Commissioner will have an influential voice in that debate. So while the Insurance Commissioner flies under the radar for many voters, this race will have real impacts on the cost and availability of insurance for Washingtonians. As you vote in this election, make sure to closely examine the candidates vying to be your next Insurance Commissioner.

Now, let's dive into my interview with State Senator and Insurance Commissioner candidate Patty Kuderer to hear more about why she's running and what she hopes to achieve in this role. Welcome, Senator Kuderer.

[00:02:30] Senator Patty Kuderer: Thank you so much for having me.

[00:02:33] Crystal Fincher: So just starting out, why are you running for Insurance Commissioner?

[00:02:38] Senator Patty Kuderer: Yeah, I realize that people don't wake up in the morning wondering who their next Insurance Commissioner is going to be, but this has been an office that's been on my radar for quite some time. And the reason quite simply is I'm motivated by moving toward universal healthcare - and it's something that I feel very strongly about. Many years ago when my daughter was born prematurely at 1 pound, 13 ounces in the NICU, she spent five months there. She had three surgeries - the first one was within 48 hours of her life. Watching her struggle was really traumatic, stressful. You feel overwhelmed and vulnerable - you know you're not going to kiss that and make it better. And watching her struggle, but to have my firm so supportive of me and to say - Go be by your daughter's side, we got you covered, don't worry about a paycheck. I was that fortunate. Only to find that my insurance company at times said they were denying some of her care because it was "experimental." As I've told people, there are times when being a trial lawyer comes in handy - that would be one of them. And I was able to get those bills paid, which were hundreds of thousands of dollars in the end - she was our million dollar baby. But I have to tell you, when I went back to the NICU and looked around at the other families who are there, and watching them with their babies struggling to live, and thinking that they had to be doing the same thing to them because we have a for-profit healthcare system. And so by definition, in order to get some of that profit, they have to deny care. Or they do deny care, even to the point where they would deny life-saving care to a tiny infant. My daughter's now 31 and second-year of law school. And all I can say is that I was very fortunate to have the resources - A] to fight back, but B] also to know about early intervention, which is, I think, a healthcare piece that we could be more invested in. And it made all the difference in the world for her to have that kind of care.

But it left an imprint on me - I really felt like we had a morally bankrupt healthcare system. And I met a doctor who was at the hospital - he wasn't her doctor, but he was there - and he was also an author. And he happened to be writing on our failed healthcare system - and he hired me to help him with his writing. So I got to research what he wrote about our failed healthcare system - how our healthcare system evolved and the problems with it, and to research healthcare in other countries and how no other country has copied us. And today we have the most costly, the most complicated, and the most challenging healthcare system in the world - and we do not have the best results. I think we can do better. I know we can do better. We created a Universal Healthcare Commission - I voted for that bill a few years ago - the Insurance Commissioner sits on that. So another reason why I want this position - because I want to be very actively engaged on that commission and help steer us in that direction.

[00:05:33] Crystal Fincher: So what do you think are the most pressing issues facing insurance consumers in our state, and how do you plan to address them?

[00:05:41] Senator Patty Kuderer: Well, healthcare is a big one. And we passed a suite of reproductive justice bills that will be monitored and implemented through the Insurance Commissioner's office. And I think in light of the Dobbs decision, these are critically important. It's important to have someone who is a pro-choice candidate in that position. We also have issues with access to mental health services, and there's an issue with parity even though we passed a Mental Health Parity Act in the early 2000s or so. We still don't have mental health parity - and we need to be looking at how do we expand access to people for those services, and how do we entice people to go into mental health services. We also have an issue with our property casualty in our state. You've probably heard about auto premiums going up and people with homeowners insurance being non-renewed, as they say, because they're in wildfire zones. The homeowners piece is directly due to climate change and also inflation - and it's a hard insurance market, Crystal - not just here, but everywhere across the country. It's a hard insurance market. And the goal here and the trick here, I think, will be to be working with the insurance companies on risk mitigation strategies for homeowners that they can employ to reduce their risk, and reduce their premiums, and stay insured. And also to make sure that the premiums that are being charged are directly related to the actual risk that's being insured. So that is the trick at this point for the property casualty. With respect to auto - again, there are a lot of reasons why those are going up. It's not that the injuries from crashes are more serious necessarily, it's just that the crashes overall are more costly because our cars are smarter. For example, I was telling someone - if you own a Tesla, you get a fender bender and you actually have to replace the entire back end of the car or the fender. So that's a whole piece and that takes a lot of time and that's six months in the shop and thousands of dollars, whereas before they used to just pull the dent out at the body shop. So, the cars have improved - they've improved safety-wise, they've also gotten smarter and help us stay out of crashes. But when there are accidents, it's more expensive to repair those vehicles. So that's another reason why - and inflation, again, plays a part in the overall increase in premiums.

But the Office of the Insurance Commissioner has actuaries there to look at these things and whether or not the premium increases are directly related to the risk being insured, the costs associated with it, et cetera - so that I think is a really important piece at the Insurance Commissioner's office. And also being a resource for people - letting them know that they can shop around, which is a really good thing to do with auto insurance in particular. But we have in our state - well, actually all over the country, again - we've seen it go more towards six-month policies. Now many, many moons ago, I did sell insurance for a short while before I dived right into law school, and I can tell you that a six-month policy was really rare. It was for a really, really high-risk individual. But now we're seeing that that's more the norm. And unfortunately, we're seeing that it's the norm with working families and our BIPOC community members traditionally. And that's a problem. And I think that there's a way to look at that six-month policy and change that to make it a year again and still be fair with the insurance companies. But I don't think that a six-month policy - just on its face - I'm not convinced that that's the best way to go. And there are other factors too. People have brought up credit scores to me as an issue - in fact, I was on the bill that would have eliminated that as a reason for rating your premium and your risk. And I can tell you, I'm not convinced that credit scores are appropriate metric for determining premiums, or even one of the metrics for determining premiums. And I would want to dig into the data - I'm very heavily data-driven. It's my nature. It's been my life's work in evidence, and I like to say that I know good data from bad data, but it will be something that we'll be looking at very closely.

[00:09:48] Crystal Fincher: One of the things I want to talk about - there seemingly is a tension between needing to have a competitive market here in the state - have several choices for consumers, and the need for companies to be profitable - with protecting consumers, making sure that pricing is fair and transparent, and they aren't being gouged with excessive rate increases. What is your approach to balancing that?

[00:10:13] Senator Patty Kuderer: Well, to start, I can tell you that I've told insurers who I've met with that you can have a strong consumer advocate as the Insurance Commissioner, and you can have a strong, healthy insurance market. The two are not mutually exclusive. And I think that it goes toward - we need to be able to have the plans, the rates that are reviewed at the OIC [Office of Insurance Commissioner] - we need to make sure that first and foremost that they are founded in fact and traditional insurance risk principles. And secondly, that they're not discriminatory, unfairly implemented. And we need to make sure that insureds have the knowledge and resources that they need to make informed decisions about their insurance. Because it is a choice. And right now, a lot of people stay with the same company forever and ever and ever. And I've heard this - I've been getting a lot of emails, I'm sure that'll surprise you, from around the state - about people who have had their insurance all of a sudden up and canceled it, and not renew them after 40 years of being with the same company. There are a lot of reasons why that happens - it can be the wildfire zone, the flood zone, etc. But it could also be that the insurance company has decided that its percentage of business in the state is too high to cover the risk that they're exposed to - their exposure - and they're cutting back. So I think what we want to do is make sure that no one is left without the protection that they need and to make sure that they have the resources that they need to make informed decisions.

[00:11:47] Crystal Fincher: So how will you promote more fair and especially transparent pricing of insurance products? Because it's hard to know what's going into a rate increase - what is that price made up of? And what penalties should there be for insurance companies found to be charging excessive fees?

[00:12:08] Senator Patty Kuderer: Well, the penalties - we have different kinds of insurance, obviously, and they have different fine schedules. And I had a bill this last session that would have updated the property casualty fine schedule - and that bill did not pass. I think that that's something that needs to happen. I can tell you as a trial attorney, I do believe that you need to be able to incentivize good behavior. And there are ways that we can do that in the Legislature. And of course, in the role of the Insurance Commissioner, I'm not going to be legislating - I can ask for legislation, but it will no longer be my role to actually make laws like it is currently. And it will be an agency-request legislation that will come back to work on that fine schedule because I do think it needs to be modernized and updated - because then you're going to see less of an incentive to "treat someone unfairly." And I just want to say, I did insurance defense work - which is when an insurance company hires you as the attorney to represent their insured in an action. So I have worked with adjusters and insurance companies that I feel have been very fair with their insurance and with third-party claimants as well for that matter. But I've also seen the abuses and I mean, I've seen them - if you look at the bills that I've dropped in the Legislature over the years, you will see a pattern - and they come out of experiences that I've had as an attorney representing my clients and how they've been treated. And I think that there are lots of things we can do to make the system more transparent, more fair - so insurers have information about how their premiums are being set, they know what factors are being considered - so that they can take whatever steps they need to to address whatever risk exposure the insurance company is looking at that it doesn't want to insure and maybe mitigate that. But it does take communication. It does take transparency. It does take information sharing. And how much of that information the insurance companies will be willing to give? I don't know at this point. Is it going to be that that's our proprietary information and we don't want to share that because we have a competitive edge right now? Don't know. We'll have to dive in, and sit down at the table and talk about these things with both the insurers and representatives of insurers.

[00:14:27] Crystal Fincher: Now, we certainly have - and will talk more about - abuses that we've seen from the insurance industry, but there are challenges that they're dealing with. What are the greatest challenges that the insurance industry is facing and how can you help that in your role?

[00:14:45] Senator Patty Kuderer: Well, I think the different types of insurance have different challenges, but quite frankly - for property casualty, I do think one of the number one challenges is climate change. What we've seen in Florida - because of the rising sea level and the increase in fierceness of hurricanes - that the private insurance market has all but pulled out of Florida for that reason. The risk is just too great. And that's something that the insurance industry isn't going to solve. And we, as legislators, have been working toward that - we did pass our Climate Commitment Act. And that's us as a state. We do have to lead as a country too. And I will say that I was pleased in the Inflation Reduction Act bill, there's the largest allocation of financial resources towards green energy, sustainability, reducing our climate change overall risk than ever before. So things like that - I think we have to be much more forward thinking on. But we're fighting some very powerful corporate interests. You probably heard about the oil companies chatting it up with one of the Republican candidates who is currently on trial. And the fact that you could sell out for a billion dollars, we're talking about people's lives 20 years from now, 30 years from now. And that's my kids and hopefully I'll have some grandkids that don't have tails at some point - and I love my dogs and the cats, but I'd really like to have a grandkid. And I'd like for my grandchildren to live in a world that's safe, and that's healthy, and that's not underwater, and that you can breathe the air, and you're not going to worry about your house going up in flames. These are real issues around the country right now, especially in the property casualty. I would say to people who are climate deniers - Go ask your insurance agent if climate change is real, because they'll tell you that it's real. And we do have to get a handle on that. How we do that - obviously, the scientists are going to have to be more engaged. So are the politicians going to have to be much more engaged around the world - but here too, and I'm really proud that Washington has been a leader in this regard. And we do owe it to - Governor Inslee has been - he's been calling out this issue for a very, very long time. And he did, I think, a really wonderful job leading on the Climate Commitment Act.

[00:17:03] Crystal Fincher: Absolutely. Well, I want to talk about that a little more - because as you brought up, insurers are increasingly pulling out of flood and fire-prone areas due to the escalating risks and costs associated with climate change. What steps will you take to ensure that property owners in these regions in our state have access to affordable flood and fire insurance?

[00:17:26] Senator Patty Kuderer: Well, we do have the program at the state as the insurer of last resort. I do not want to see that become the insurer of first resort. So that does mean that we need to make sure that we have a healthy insurance market here in Washington. I do think that it requires us to help educate people on how they can reduce their risk. The insurers, when they go out and determine if they're going to insure a specific piece of property or not, they're looking at certain factors - what are they? They're not the same necessarily for each insurance company. Like when you determine what's a wildfire zone, there's no uniformity there. Should we have a uniform standard that's communicated to all insureds so they understand what can they do to reduce their risk for wildfire? What can they do to reduce their risk for flood? But there's only so much that's within their control. Again, I do think that it is something that needs to be addressed at the national and international level for sure. But that's what I would say in the meantime is - we have to make sure insureds know what they can do to reduce their risk, and then have a healthy market where they can shop around and get the best for the risk that they're insuring.

[00:18:35] Crystal Fincher: Should the state and your office play a role in funding and educating consumers on what they can do to help mitigate risks - like reducing their flood risk, reducing their fire risk - to help make them more insurable and insurable at lower rates?

[00:18:53] Senator Patty Kuderer: Yeah, absolutely. In fact, I have said that I don't think that the commissioner should sit in Olympia. I think we need to go around the state talking to insureds about these very issues and helping to educate them. I know the website has been updated over the years, and I think that they do a pretty good job overall of giving information to insureds. But I know that there's more that we can do - and I think face-to-face. And people understand that I want this office to be consumer-centered - and that means going out and talking to folks about what their specific issues are and how do we solve them. I'll give you an example. I was talking to a gentleman who - his wife is in memory care and she can't leave to go to the dentist. And it's been so incredibly difficult for him to have coverage for a mobile dentist to come to the memory care facility and perform dentistry there. That should not be an issue. This is not a situation where this person is choosing not to go to a dental office. I think that that should be part of the overall plan design, and that's something that - the Legislature has the right to shape plan design. And the Insurance Commissioner's office can be very proactive in asking the Legislature to make certain plan design changes. I do think that when you make changes like that, you do sit down and you talk to all the stakeholders so that you don't end up with any unintended consequences or consequences that you can avoid - because you know about the issue now and you can address it in the proposal. And I think that in the end is what I would see us doing - is going around the state and being a resource for people and helping them with their insurance needs. I think I mentioned early, before we started recording, that this office hasn't been open in 24 years. And a lot of people don't know that we have an Insurance Commissioner, let alone that we elect one. And I think that it's important - I want people to understand that we're there to help them. And so I want to be very proactive in that regard - same with the website, same with our complaint procedure - we need to make sure that that's robust and that people are, even if they don't agree with the response that they get, at least they know they've been heard and there's been action taken in looking at the complaint.

[00:21:16] Crystal Fincher: Is there a way to make health insurance billing less opaque? From dual billing of provider and facility fees, to annual physicals that turn into expensive problem visits and follow-ups, to out-of-network providers working in in-network facilities, and differing insurance company policies - going in for medical care as an end user can feel like a crapshoot in terms of understanding what care they can get for what price, even when they're doing their due diligence upfront. What can you do to improve that?

[00:21:50] Senator Patty Kuderer: Well, we have passed the Balance Billing Act, which is to avoid the very situation that you talked about where you have an out-of-network provider in an in-network hospital that performs a service for someone and the consumer ends up with a balance billing. We ended that practice a few years ago, a couple of years ago, I think now. And in terms of the actual billing of medical claims, I think one of the things - again, it goes to information being relayed to the insured - how this works. I had a bill - again, it did not pass this year - but it was a bill dealing with plain language in insurance contracts. I'm surprised that we don't have that in our state yet. It was unfortunately opposed by some in the insurance industry. I think that we need to move in that direction so people understand what is covered, what's not covered, what the cost is going to be, et cetera. But if we go to universal healthcare and we streamline the process so that we don't have these situations, these things will be taken care of. There won't be an issue of balance billing. There won't be issues of surprise - you have to pay for this now too. I think we have to move in that direction and I think there's a natural momentum for us to move in that direction. I have one idea of what it should look like - I've been talking about an interstate healthcare compact with the West Coast states and setting it up that way - leveraging Medicaid dollars, etc. And you'd have to have a health tax on employees and a premium health tax on employers, potentially other revenue sources as well. But the idea would be to really streamline the process. As I said, our process is so complicated - that adds to the cost, it really adds to the cost.

And I'll give you another example. One of my bills that did pass this year was a pharmacy benefit manager bill. It's the first time in several years that any state's been able to put any guardrails around pharmacy benefit manager pricing practices. And they're the middleman in the drug chain, and they take a lot of money out of the system. They make billions in profits. And this bill ended the spread pricing, and also put some guardrails around how they charge people for their services, and also gave the Insurance Commissioner the opportunity to kind of look under the hood - that's another opaque area, if you will. And that bill was bitterly fought - it was heavily bipartisan and bitterly fought. My second on that bill was Senator Shelly Short, who's one of the most conservative Republicans in the Senate. And she and I were lockstep on that bill, and we made sure that it had teeth - that there was a way to enforce that bill - because the drug costs in this state were getting out of hand. Remember, we had to pass a bill to stop the drug companies from charging more than $35 a month for insulin - things like that. We passed my bill a few years ago to require insurance companies to pay for 3D mammograms - it was the better mousetrap, it caught cancer sooner, fewer false positives, but they didn't want to pay the $50 or so extra charge for that. We did plan design, and that's what I'm talking about when it comes to helping consumers in the state. But eventually, I think we have to be moving toward universal healthcare. We're not going to get there overnight. The implementation will take a very long time, but we can get there, and we have to have the blueprint in place.

[00:25:06] Crystal Fincher: Many consumers have talked about the problem of insurance companies improperly denying claims that should be covered, only to eventually have those decisions overturned on appeal - the denial of the claim is reversed. So it's something that should have been covered in the first place, there's an inexplicable denial. Policyholders have to spend a lot of time and energy, while they're also usually dealing with whatever this health issue is that precipitated the claim, and then it's eventually covered as it appears that it should have been the entire time. And it really seems like they were just hoping that they would accept the denial - saving the insurance company money - and really forcing policyholders to work to receive the coverage that they're paying for and should have automatically received, causing significant financial and emotional strain for policyholders and eroding public trust in the insurance industry. How will you work to identify and address patterns of improper claims denials? And in cases where a pattern is identified, what steps will you take to ensure that policyholders are made whole and the insurer is held accountable for any harm caused?

[00:26:22] Senator Patty Kuderer: Yeah, it's a real problem. And it does happen quite a bit, actually - and I know from my experience as a trial lawyer. But I will say this about Washington - 20 years ago, roughly, we put into law, into statute, the Insurance Fair Conduct Act [IFCA] . It is one of the strongest enforcement mechanisms against this kind of situation in the country. And it impacts all first-party claims with the exception of some medical claims that are not covered by PIP [Personal Injury Protection] . And what that law says is if that situation is what the case is - so there's been an unjustified denial that has no basis in fact or law whatsoever, it just is a way to delay paying the claim - so that if they've invested money or whatever that it goes in and they can get as much interest on what they've invested for as long as possible. IFCA allows you to hire your own attorney. And I can tell you from experience, having just sent a letter and threatening that we're going to file a lawsuit under the Insurance for Conduct Act, that claim gets resolved. Because when it is truly unjustified, they don't want to pay my fees too, because that's what IFCA says they have to do. That is a really strong enforcement mechanism and it's something that a lot of insureds don't know about - they think they can't afford a lawyer for 300 bucks, 5,000 bucks - but if it's a first-party claim that was unjustifiably denied, you'll incentivize a lawyer to file the claim if they have to. All I can tell you, it would probably just be the letter to resolve it, but you would be able to get justice much more quickly by utilizing an attorney. But people don't know that, so I want to tell people about IFCA. And I'd also like to see IFCA strengthened, because I think it is one of the strongest and best enforcement mechanisms we have against unjustifiable denials. And I've seen a lot of those in my lifetime, let me tell you.

[00:28:16] Crystal Fincher: Yeah, and it feels like I see - just from people on social media - weekly reports from people here in Washington State talking about that. I think you are correct that a lot of people just don't know what their rights are, what the recourse is. So how can you, in your role as Insurance Commissioner, further educate the public, engage with the public, and empower people to exercise their rights with insurance?

[00:28:44] Senator Patty Kuderer: Again, I think it is making sure that they have the information - that it's on our website, that we're going around the state and talking to people and letting them know about this. I really do view my role as empowering insureds as much as possible. There's a reason that our statute doesn't just say that the Insurance Commissioner is to provide oversight and regulate the insurance industry. It also says that the Insurance Commissioner is to act in the public interest. And I think the reason for that is that when they passed the statute, they understood that there was an inherent power imbalance between the insurance industry and insureds. And this was a way of leveling the playing field a little bit, because you could have the abuses that we talked about. And I think that piece about acting in the public interest, given the way the statute is drafted, is equally important as the regulation and oversight. So I intend, like I said, to make the office consumer-centered, putting them first, and making sure that when there's a dispute - if it's something that we can assist in, we definitely will.

[00:29:49] Crystal Fincher: Do you believe our state and as Insurance Commissioner, would you move to make gun owner liability insurance mandatory?

[00:29:57] Senator Patty Kuderer: Yes. We have accidental shootings here, just like there are accidental shootings all over the country, given the sheer number of weapons, guns that we have in the country. And it's bound to happen and what the gun owner liability insurance is really designed to do - it's to incentivize safe storage, incentivize training, incentivize possibly getting smart technology where your weapon can't be fired unless your fingers are holding the weapon. I think we can do better when it comes to this. The Second Amendment as a constitutional right will be with us, I believe, for forever, probably. But I will also say that with rights come responsibilities. And right now, when someone is accidentally shot, suffers injuries, and there's no recourse against the gun owner - what you end up having is taxpayers a lot of times paying some of the bill. And that's in the case of if you're negligent - you leave your gun in your car in plain sight and someone grabs it and commits an intentional shooting - and that person who is shot is entitled to crime victims' fund. And I think it's just smart policy. Right now, there are some homeowners policies that do cover accidental shootings in some situations. It's not going to be cost-prohibitive. I do think that there was some concern with the agents, whether - would they be held liable if they didn't determine the exact number of weapons. But I think there's a way we can solve that by creating a form, something that the insured has to make representation - Yes, I have weapons. No, I don't have weapons. This is the number I have - because the insurance company needs to know what the potential risk is if they're going to be insuring it. And the number of weapons would be directly relevant to that - where they're stored, do you have training? - things like that.

[00:31:48] Crystal Fincher: There's an increasing amount of personal data collected by insurance companies and data that they have access to, like data from smart cars about how and where we travel and what our driving behaviors are, details about reproductive or gender-confirming healthcare treatment, whether someone owns a gun - and that information can be used to expose people to legal liability, penalties, and others. What steps will you take to ensure that policyholders' privacy rights and data is protected, their information is secure and not vulnerable to release to law enforcement?

[00:32:28] Senator Patty Kuderer: Well, the good news is we passed the My Health, My Data bill a couple years ago - that was my seatmate's bill, Representative Vandana Slatter - and that protects healthcare data from that. And with respect to the auto companies, the automobile makers that are selling this data to insurance companies right now - it's one thing if the person who owns the vehicle has consented to that, it's another if they have not. And right now there are some companies that have these apps that you can put on your phone or into your car that monitor how you drive - you choose to do that. And if you're driving in a way that indicates you are a lower risk for an accident, the net result of that is that you're to get a lower premium. But if you don't agree to that - and there are some instances when these apps are in the car already - and whether you turn them on or not, they can still record data. It's like Siri listening all the time. It's really important, I think, for there to be consent when we're talking about your personal data. If you consent, I don't have a problem with that. But if you haven't, I don't think that this should be for sale. I just don't. I don't think it's what the consumer expects when they buy a car - that information transmitted from the automobile maker is going to go to the insurance company to determine that person's premium - that's not what they expect when they buy a car. They expect to get a car that they can drive and it's going to work and etc, and that they can go back to the dealership for repairs and maintenance, etc. But not selling personal private data on how you drive in traffic. The other thing about that is that there's no context to that either. You can slam on your brakes - they look at how often you slam on your brakes, for example. Well, if you live in a rural area and there's a lot of deer around there, you might be slamming on your brakes a lot - that doesn't mean that you're driving recklessly. And so because there's no context, I think it's even more dangerous that we don't have some parameters around that.

[00:34:29] Crystal Fincher: So what parameters would you look to put on that as Insurance Commissioner?

[00:34:33] Senator Patty Kuderer: First and foremost, consent. You have to consent for that data to be considered by your insurer. I just feel that's really critically important.

[00:34:43] Crystal Fincher: Makes sense. What's your stance on regulating new and emerging insurance products like cyber insurance or usage-based auto insurance?

[00:34:52] Senator Patty Kuderer: Well, I'd have to look into that - that isn't something that I've thought about, honestly. But new insurance products would have to be reviewed by the Insurance Commissioner's office and would have to be approved. I do know that there was a company a while ago that was purporting to sell gun owner liability insurance, but really wasn't selling that at all. And the Insurance Commissioner's office sent a cease and desist and they stopped selling in the state. That's another part of the role of the Insurance Commissioner - is to make sure that you don't have companies that purport to be insurance that really aren't insurance operating in the state and undercutting the insurers who are registered in the market here now.

[00:35:32] Crystal Fincher: What's not on people's radar? What haven't we talked about that's important to address?

[00:35:40] Senator Patty Kuderer: I think WA Cares, which is long-term disability insurance - that bill, I think, was visionary and incredibly smart. It is a small price to pay for what you may end up needing. Many people will need long-term care in their lifetime. And the long-term care market, the disability market is in disarray. It is the only insurance that is exempt from Obamacare. So, they can have lifetime caps and they can use pre-existing conditions to deny you coverage. The coverage traditionally does not cover renovations to your home. If you're temporarily in a wheelchair and you need a ramp, that insurance likely will not pay for it. And it will not pay for your loved one who's going to stop working for a while to take care of you for six months. WA Cares does both of those things. And WA Cares is set at a rate that is the midpoint, meaning that about 50% of those who need long-term care, they will have enough coverage with WA Cares. But what it does for the other 50% that may need extended long-term disability care is it extends our Medicaid dollars. And I can tell you why that's important. I had a client who was hit by a drunk driver. He was just out for a motorcycle ride and ended up a quadriplegic, his wife was killed. And the insurance company was going to have to pay the money, but they didn't. They waited and waited and waited. And in the meantime, he had to spend down into poverty to qualify for Medicaid services so he could have in-home healthcare. This is the kind of thing that I find morally reprehensible. But what WA Cares would do is it would extend our Medicaid dollars to help individuals like him, who really need that permanent long-term care. And that, I think, is really important for us to be looking at. And I genuinely hope your listeners understand the value of WA Cares and how incredibly visionary it is, and will vote down the initiative to repeal it.

[00:37:46] Crystal Fincher: Absolutely. As you said, that will be on our ballots to vote on in November, and it's a very, very important issue. Now, as we close this interview today and people are trying to figure out what the differences are between you and your opponents, what do you tell them? What sets you apart, and why should they support you?

[00:38:09] Senator Patty Kuderer: Well, I think what sets me apart is I am the only one in this race that has a proven track record of being a consumer advocate. I've been a consumer advocate as a litigator. I've been a consumer advocate as a legislator. And I intend to take that approach into the Office of the Insurance Commissioner. And I also think I am the only one talking about universal healthcare. And for me, it is definitely something that I intend to make front and center. I know we need to move in that direction, and we're not going to move in that direction as a state unless we have someone in that role who is committed to seeing us go in that direction. I'm not saying I have all the answers on what that looks like. I'm certainly open to being persuaded to whatever ideas are out there as long as we reach the ultimate goal, which is to make sure that no person has to worry about whether they can access healthcare and have to worry about whether they're going to not only go in debt, but maybe even have to file bankruptcy because of medical debt - which is the number one reason for bankruptcy in our state or our country right now - is our medical bills. And I also find that reprehensible. It shouldn't be that way. Healthcare, for me, is a human right. I believe that in my core, and I will be leading the Insurance Commissioner's office with that in mind.

[00:39:27] Crystal Fincher: Well, thank you so much for taking the time to share your vision with us today, to talk through these issues - really important to everyone in this state. And really thank you for your time.

[00:39:38] Senator Patty Kuderer: Thank you, Crystal.

[00:39:40] Crystal Fincher: Thank you for listening to Hacks & Wonks, which is produced by Shannon Cheng. You can follow Hacks & Wonks on Twitter @HacksWonks. You can catch Hacks & Wonks on every podcast service and app - just type "Hacks and Wonks" into the search bar. Be sure to subscribe to get the full versions of our Friday week-in-review shows and our Tuesday topical show delivered to your podcast feed. If you like us, leave a review wherever you listen. You can also get a full transcript of this episode and links to the resources referenced in the show at officialhacksandwonks.com and in the podcast episode notes.

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