Washington health insurance
A look at health coverage and the impact of Obamacare in the Evergreen State
By Louise Norris
August 6, 2014
If you live in Washington – or you’re thinking about moving there – you’re probably curious about issues that impact the overall health of the state’s residents. There are numerous factors that might affect how you view the state’s approach to providing health coverage and health care. Here’s a partial list for your consideration.
Washington health ratings
The Commonwealth Fund’s Scorecard on State Health System Performance 2014 rated Washington 15th out of the 50 states and District of Columbia – a gain of three spots from 18th in 2009. Washington‘s Scorecard includes details on how the rankings are calculated.
In 2013, America’s Health Rankings rated Washington 14th among the 50 states. Washington’s rating is helped by a physically active population, infrequent incidence of preventable hospitalization, and low rates of infant mortality, premature birth, and low birth weight. The state’s rating is hampered by a high prevalence of drug deaths and pertussis, and relatively low immunization rates.
Additional information is available regarding the state’s specific disease incidence in a summary put together by Trust for America’s Health. The details for Washington are in the 2014 listing of Key Health Data About Washington.
You can also view Washington health data on a county level with this interactive map that ranks the counties in Washington based on their overall health outcomes and health factors.
Washington’s elected officials and the ACA
In 2010, both of Washington’s U.S. Senators – Maria Cantwell and Patty Murray – were supportive of the health reform law. Both are still in the Senate.
In the House, the six Democratic Representatives voted yes and three Republican Representatives voted no. The U.S. House currently includes ten Representatives from Washington: The six Democrats are supportive of the ACA, while the four Republicans support either full repeal or significant modification of the law.
Governor Jay Inslee, a Democrat, is very supportive of the ACA and has enthusiastically worked with his state officials to implement the law in Washington. The state is running the Washington Health Benefit Exchange and also opted to expand Medicaid, enrolling more than 900,000 people in expanded Medicaid/CHIP by the middle of April.
How did the ACA help Washington Residents?
In 2012, about 16 percent of non-elderly Washington residents were uninsured. Various studies have projected nearly a 50 percent decrease as a result of Obamacare, anticipating an uninsured rate of just 8.27 percent following ACA implementation. That would put Washington in 9th place in the U.S. for lowest total uninsured rate.
Washington enrollment in QHPs
Washington Health Benefit Exchange has eight carriers participating in 2014, but four more have filed plans to participate in 2015, which would bring the exchange to 12 carriers, ranking it among the top in the country in terms of consumer options.
By mid-April – when the 2014 open enrollment period ended – 163,207 people had completed their enrollments in private plans through the exchange. In late 2013, shortly after open enrollment began, the Kaiser Family Foundation estimated the potential market for the exchange in Washington to be 507,000 residents, and that 272,000 of them would likely be eligible for subsidies to lower their premiums.
Washington Medicaid/CHIP enrollment
A large part of the success Washington has had with Obamacare is due to the state’s use of federal funding to expand Medicaid eligibility to 138 percent of poverty. In early 2014, the Kaiser Family Foundation estimated that about 47 percent of the uninsured population in Washington would be eligible for expanded Medicaid or CHIP.
As of mid-April, 909,752 people had enrolled in Medicaid through the Washington exchange. Enrollment in Medicaid is year-round, so that number continues to increase, making an ever-growing dent in the state’s uninsured rate.
Does Washington have a high-risk pool?
Before the ACA brought guaranteed issue health insurance to the individual market, plans were underwritten in nearly every state. Pre-existing conditions could prevent an applicant from getting a policy at all, or could result in significantly higher premiums or policy exclusions. The Washington State Health Insurance Pool (WSHIP) was created in 1987 to provide people with an alternative if they weren’t able to get private health insurance because of their medical history.
Now that the ACA has been implemented, all health insurance plans are guaranteed issue, largely eliminating the need for risk pools. But WSHIP is one of a few state-run pools that is still operational and will be for the next few years (and indefinitely for some Medicare enrollees).
The pool closed to most new non-Medicare enrollees at the end of 2013, but existing members can stay on the plan until the end of 2017. Under some conditions, WSHIP is continuing to enroll Medicare members as well as some non-Medicaid eligible applicants.
State-based health reform legislation
The Washington legislature has been very active in the area of healthcare, addressing numerous issues that impact public health. Here’s a summary of recent Washington bills related to healthcare reform: