At each Open Enrollment period in Washington State, residents can shop and enroll for health insurance via the marketplace. Based on their income levels, residents may also qualify for state subsidies that will reduce premium costs and deductibles accordingly.
As our nation grapples with how best to reform healthcare, the state of Washington is setting an example by pioneering its own exchange. This page provides a concise summary of current law as well as details regarding legislation or lawsuits seeking to alter or repeal it.
The Affordable Care Act, more formally known as the Patient Protection and Affordability Care Act (PPACA), was signed into law by President Obama on March 23, 2010. This expansive health law will have lasting implications for all Washingtonians; however, different groups may experience greater or lesser ramifications of its passage and implementation.
Employers are required to offer coverage to their employees or pay a tax, and state or multistate-based exchanges have been established to assist individuals and small businesses with purchasing coverage. Furthermore, Medicaid eligibility was expanded for low-income individuals as well as prohibition against insurance companies excluding preexisting conditions or canceling coverage policies.
Funding cuts could also limit research and development of innovative medical treatments, including those used to combat some of the world’s deadliest diseases such as cancer, AIDS, Multiple Sclerosis and diabetes. This would have an immediate effect on Medicare and Medicaid patients in Washington and across the country who will have less access to care and less say over medical decisions affecting them.
The Washington Health Benefit Exchange
The Washington Health Benefit Exchange (WHBE) is an online marketplace where consumers can shop, compare, and enroll in health insurance policies. In addition, it operates a toll-free consumer hotline and provides information regarding small business options.
WHBE utilizes its planning and Level One Establishment grants to develop an online experience tailored to Washington residents’ needs. In particular, its technology platform must be flexible enough to handle sudden spikes in traffic without impacting performance or service availability.
The WHBE has achieved tremendous success in providing its customers with an enjoyable shopping experience, but its back-end infrastructure has struggled under surges of demand during special enrollment periods like COVID-19. Their server technology environment and software were reaching end of life support; therefore they required improvements between various back-end technologies used for processes like applications, identity verification and eligibility results; their solution: switching to a modern container platform which could deliver higher uptime at reduced costs while increasing scalability.
The Public Option
As part of an attempt to bridge the gap between full single-payer plans and privately purchased insurance markets, some pragmatic liberals have advocated for the introduction of public option plans into individual marketplaces as a less disruptive means to increase government involvement without sparking an anti-government backlash.
Early efforts at creating a public option have proven disappointing, however. Insurance and provider companies are less willing to cooperate with programs that eat into their profits and revenues, while consumer buy-in remains limited.
As such, state-based quasi public options like those introduced in Washington State and considered in Colorado appear more promising models than individual public plans. We strongly urge legislators to give these alternatives consideration when reviewing various “repeal and replacement” bills. At its core, all stakeholders seek healthier communities with open hospital doors; we can only achieve that through providing individuals with access to affordable coverage options.
If you need health insurance coverage, the Marketplace can help you find an Affordable Care Act (ACA) plan that’s just right for you. Applications can be submitted during Open Enrollment period which runs annually between November 1 and December 15; plans must cover 10 essential benefits, and you may qualify for financial help with premiums and cost sharing (copays/coinsurance etc).
Washingtonians now have access to Apple Health (Medicaid), as well as low-cost private health plans through the Marketplace, thanks to the Affordable Care Act’s expansion of Medicare to cover both hospital expenses and outpatient services as well as doctor visits, x-rays and prescription medication costs.
Washington state plans on seeking federal approval in 2024 so undocumented residents may purchase Marketplace coverage through the Exchange and receive premium subsidy assistance like other eligible individuals. Five of 12 insurers offering plans through the Exchange offer public option plans in some counties.