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PROVIDER CHOICE MEASURE FAILS

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SEATTLE-Washington voters last week rejected a measure that would have required health plans to reimburse any provider who delivers covered services to a participant.

Initiative measure 673 also would have allowed enrollees to keep their doctors even if they changed jobs or health plans. The measure's definition of doctors included chiropractors, podiatrists, naturopaths and pharmacists.

The campaign mostly pitted managed care organizations against chiropractors who backed the measure. However, Washington state employers also opposed the measure, arguing it would have raised the cost of health benefits and impeded efforts to make health care delivery more efficient.

"We would virtually not have been able to have managed care products available to our employees," said Dorothy Graham, president of the Washington Health Care Purchasers Assn. and director of human resources for Puget Sound Energy in Bellevue, Wash.

Nearly 70% of voters opposed the measure. The Seattle-based Patient Choice Coalition said one reason voters turned down the idea was that the coalition was outspent 4-to-1 on advertising. The coalition, made up of labor groups, consumers and medical groups spent $400,000 on its campaign.

However, employers fear the battle is not over.

"We are just waiting for the other shoe to drop," Ms. Graham said. "Initiatives have generally not been successful in the state, although they do take a lot of time and energy."

The attempt to legislate which providers can deliver health plan services most likely will come up again after the state Legislature reconvenes in January.

Another measure on the Washington ballot would have banned discrimination against gays in the workplace but did not take a position on domestic partner benefits.

That initiative failed to gain approval, with 60% of the voters against it. The state's larger employers did not take a position on the issue, because many of them already have similar non-discrimination policies.