Washington enrollment update
- Open enrollment for 2018 coverage extended to January 15
- Off-exchange: if your insurer is leaving the market, you get a special enrollment period
Washington State overview
Washington consistently ranks well when it comes to public health, and its state-based health insurance exchange also performs among the best in the nation. By December 15, 2017, enrollment in Washington Healthplanfinder had already surpassed total enrollment from the year before, despite a full month remaining in open enrollment for 2018 coverage (Washington Healthplanfinder extended open enrollment until January 15, 2018).
Washington’s individual market remains robust, with seven insurers offering plans in the exchange for 2018. But coverage areas are localized, and some parts of the state were initially facing the possibility of having no insurers in the exchange for 2018. That crisis was averted, however, and residents throughout Washington all have at least on insurer offering plans in the exchange for 2018.
2017 Washington Healthplanfinder rates, carriers
Washington’s exchange started out with eight carriers in 2014, grew to 10 in 2015 and 11 in 2015. At the end of 2016, Health Alliance Northwest left the exchange and UnitedHealthcare of Washington left both Washington’s exchange and the individual market. That left nine carriers with plans available through Washington Healhtplanfinder in 2017.
For 2018, Community Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options (formerly Group Health Options) are exiting the individual market entirely. But there are still seven insurers offering plans in the exchange for 2018 (details here, including information about average rate increases)
Washington health ratings
In 2015, America’s Health Rankings rated Washington 9th among the 50 states, an improvement from 13th in the 2014 rankings. While the state did not rank No. 1 for any measures, it was among the top 10 for many, including clinical care (i.e., dentists, primary care physicians, low birthweight, and preventable hospitalizations).
The Commonwealth Fund’s Scorecard on State Health System Performance 2017 rated Washington 10th out of the 50 states and District of Columbia, a gain of six spots from 16th in the previous report. Some of the health indicators for which it improved were: adults ages 19–64 uninsured; children ages 0–18 uninsured; adults who went without care because of cost in the past year; and adults with a usual source of care. The Commonwealth Fund’s report notes that Washington is among the states with the largest jump in rankings for 2017.
The state’s scorecard includes additional details on how the rankings are calculated.
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 2016 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.
How has Obamacare helped Washington residents?
Since the Affordable Care Act took effect in 2013, Washington has seen one of the nation’s greatest reductions in percentage of uninsured residents.
According to US Census data, 14 percent of Washington residents were uninsured in 2013, and that had dropped to 6 percent by 2016. For perspective, the national uninsured rate was 14.5 percent in 2013, and had fallen to 8.6 percent by 2016.
Washington enrollment in qualified health plans: 2018 sets an all-time record
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.
When the first ACA’s open enrollment period ended, mid-April 2014, a total of 163,207 people had completed their enrollments in qualified health plans (QHPs) through Washington’s exchange, Washington Healthplanfinder.
Although several thousand more people enrolled after open enrollment began as a result of qualifying events, total enrollment in private plans had dropped to 147,888 people as of the end of July 2014. This attrition rate is to be expected, as people move in and out of the individual market on a regular basis.
During the three-month-long open enrollment period for 2017 coverage, more than 225,000 people enrolled in plans through Washington Healthplanfinder. By early 2017, effectuated enrollment stood at 184,070, with 63 percent of enrollees receiving subsidies.
And for 2018, more people had enrolled by December 15, 2017 than enrolled during the full open enrollment period the year before. As of December 15, 2017, enrollment stood at more than 230,000 people, with another month remaining in open enrollment for 2018 coverage (Washington Healthplanfinder extended open enrollment by one month).
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.
Gov. 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.
When the ACA was implemented in 2014, Washington accepted federal funding to expand Medicaid eligibility to those earning up 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.
By the end of July 2014, 1,135,782 people had enrolled in Medicaid through the Washington exchange. But only 552,017 of them were new enrollees. The rest were existing Medicaid beneficiaries who were renewing their coverage through the exchange – all Medicaid enrollments and renewals are now processed through Washington Healthplanfinder.
As of June 2016, Washington’s monthly Medicaid enrollment had grown 59 percent from late 2013, which is the seventh largest increase among the 50 states and District of Columbia.
These numbers will continue to change since Medicaid enrollment continues year-round.
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.
Medicare in the Evergreen State
As of 2013, about 85 percent of Washington Medicare recipients were eligible based on age alone, while 15 percent qualified as the result of a disability.
Medicare Advantage plans offer Washingtonians an alternative to Original Medicare. These plans are an option for consumers who want additional benefits beyond what traditional Medicare offers. 32 percent of Washington Medicare beneficiaries selected a Medicare Advantage plan. Nationally, 31 percent of Medicare enrollees choose Medicare Advantage.
37 percent of Washington Medicare beneficiaries also have a Medicare Part D plan to gain stand-alone prescription drug benefits. This number is much lower than overall percentage of U.S. Medicare beneficiaries who select Part D coverage: 45 percent.
State-based healthcare 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: