By Louise Norris
February 20, 2014
By February 1, private plan selections in the Washington exchange had been finalized for 88,945 applicants. This was an increase of nearly 18,000 people just since the middle of January. The total puts Washington behind only eight other states, all of which have significantly larger populations. In addition to the private plan enrollments, 361,743 people had enrolled in Medicaid through the Washington exchange. Medicaid currently accounts for about 80% of the exchange’s total enrollment, but that is down from about 90% three months ago. Another 184,317 people had enrolled in private individual plans outside of the exchange in Washington as of the end of January. The state expects total private enrollment on and off-exchange to exceed 300,000 by the end of March.
In addition to the total completed enrollments, by January 28 there were 81,000 applicants who had completed everything except paying the first premium. Insurers and the exchange have been working together to make sure that everyone who was trying to enroll was able to do so, being flexible on payment deadlines as much as possible. In most exchanges, insureds pay premiums directly to the carriers. But in Washington, enrollees pay their premiums directly to Washington Healthplanfinder and the exchange then sends the premiums out to each insurer.
Enrollees now have until February 23 to select a plan with a March 1 effective date. The 23rd is the deadline each month in the Washington exchange (in most states, it’s the 15th).
After three months of open enrollment, young people (18 – 34) represented only 20% of the completed applications in the Washington exchange. But that total grew to 23% by the end of the fourth month of open enrollment, indicating that young people are starting to sign up in larger numbers. Washington is now only slightly behind the national average of 25% of enrollees being 18 – 34.
In a December teleconference, Washington Healthplanfinder CEO Richard Onizuka described very high public interest, sharply increasing awareness of the exchange, highly satisfied consumers, and call center volume that has been four to six times what was originally projected. The exchange doubled its call center staffing in December in order to more efficiently handle the volume. They later added a triage feature to the call center, so that calls are initially answered within just a few minutes, and then routed to where they can best be handled.
Washington Insurance Commissioner Mike Kreidler and Governor Jay Inslee have taken a strong progressive stance with regards to consumer protections: existing plans that do not meet ACA standards must end as of December 31, being replaced on January 1 with new, ACA-compliant policies. Following President Obama’s announcement that carriers could extend existing plans into 2014 if states allowed it, Kreidler and Inslee were quick to declare that Washington would not allow non-compliant plans to continue into 2014.
Washington was one of the first states to move ahead with a state-run health insurance marketplace as envisioned by the Affordable Care Act. Former Gov. Chris Gregoire signed legislation creating the state exchange in May 2011. In March 2012 Gregoire signed additional legislation, which further defined how the exchange will be governed and operated.
The Washington Health Care Authority (HCA) helped establish the Washington marketplace. HCA transitioned governing authority to an 11-member board of directors in March 2012. The governor appointed eight voting members and a board chairperson who votes only in if needed to break a tie. In addition, the insurance commissioner and the administrator of the Health Care Authority are non-voting members.
Eight insurers are selling individual policies through the Washington Healthplanfinder:
The carriers are offering a total of 46 individual policy options, but not all options are available in all counties. Pediatric dental-only coverage is being offered by Delta Dental of Washington, Kaiser Foundation Health Plan of the Northwest, LifeWise, and Premera Blue Cross in all 39 counties.
The federal government is funding the Washington Healthplanfinder in 2014. In 2015, marketplace operations will be funded by the state with $21 million that was previously earmarked for the state’s high-risk insurance pool, which will be operated through the exchange, and with a 2 percent tax on premiums on plans sold through the exchange.
According to the U.S. Department of Health and Human Services (HHS), about 835,000 Washington residents are eligible to use the new marketplace. The Washington insurance commissioner’s office estimates that 477,400 residents will qualify for subsidies, and state has a target of enrolling 130,000 people through the marketplace by Jan. 1 and 280,000 people in 2014.
Washington Health Benefit Exchange
Information about marketplace planning and development
State Exchange Profile: Washington
The Henry J. Kaiser Family Foundation overview of Washington’s progress toward creating a state health insurance exchange.