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Washington health insurance

Eleven insurers offer individual-market health plans in Washington State for 2019. Short-term plans are now available with 364-day terms.

Health insurance in Washington

Washington’s health marketplace

Washington State operates its own exchange, Washington Healthplanfinder. The state also has a strong off-exchange market (though subsidies are only available through Washington Healthplanfinder.)

Open enrollment for 2019 coverage technically ended on December 15 in Washington. But two days after the enrollment window ended, the exchange announced that Washington residents would have a few additional days to sign up for 2019 coverage. Anyone who contacts the exchange by December 20 will be allowed to enroll in a plan with a January 1, 2019 effective date, and will have several extra days to make their plan selection. But after that, Washington residents will only be able to enroll in ACA-compliant coverage for 2019 if they have a qualifying event.

Carrier participation in the exchange is robust, with 11 insurers offering 74 individual market plans for 2019. Seven insurers are offering on-exchange plans.

The average proposed rate increase for individual market plans was over 19 percent. But the rate changes were reduced during the rate review process, and the average approved rate increase ended up being about 13.6 percent. Though high compared with other states for 2019, the increase was significantly less than the 36 percent increase that applied in 2018.

243,000 Washington residents enrolled in plans for 2018, far exceeding the previous year’s numbers. As a result of the increased enrollment, the exchange lowered their per-person-per-month exchange fee by 55 percent for 2019.

Read more about Washington State’s marketplace.

Medicaid expansion in Washington State

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.

As a result of Medicaid expansion, total enrollment in Washington Medicaid and CHIP grew by more than 622,000 people between the fall of 2013 and August 2018. That was an enrollment growth of 56 percent, the eighth-highest percentage increase in the nation.

Read more about Medicaid expansion in Washington State.

Short-term health plans in Washington State

Washington insurance regulators have implemented new rules for short-term health insurance plans, which will take effect in January 2019, limiting the plans to no more than three months in duration and prohibiting renewals.

The state regulations that take effect in Washington State in 2019 will also include a list of other provisions designed to help consumers avoid confusion during open enrollment and protect buyers with pre-existing conditions.  Only one insurer offers short-term plans in Washington State.

Read more about short-term health insurance in Washington State.

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 U.S. 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. By 2017, the uninsured rate in Washington had inched up a little, to 6.1 percent (nationwide, the uninsured rate also increased slightly in 2017, after the Trump Administration took office, to 8.7 percent).

As a result of Washington’s decision to expand Medicaid (Apple Health), enrollment in Washington Medicaid and CHIP grew by 57 percent between the fall of 2013 and October 2017.

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 and have continued to defend the ACA while calling for improvements to the law.

Washington’s U.S. House delegation includes ten representatives, with a six-four margin for Democrats in 2018. The six Democrats are supportive of the ACA, while the four Republicans support either full repeal or significant modification of the law. In the 2018 election, the 8th District flipped with Democrat Kim Schrier’s win, so Washington has a 7-3 Democrat-Republican split for the 2019/20House session. Part of Schrier’s campaign platform was a push for an eventual transition to Medicare for All.

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.

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 September 2018, Washington Medicare enrollment reached 1,319,416, which is about 17.5 percent of the state’s population – slightly lower than the national average.

As of 2016, about 86 percent of Washington Medicare recipients were eligible based on age alone, while 14 percent qualified as the result of a disability.

In Washington, Medicare spent about $7,680 per enrollee in 2016 (for enrollees with Original Medicare). That’s 19 percent lower than the national average, and Washington is one of just eight states whre the per person cost was under $8,000.

Medicare Advantage plans offer Washingtonians an alternative to Original Medicare, and there are pros and cons to each option. In 2017, 30 percent of Washington Medicare beneficiaries selected a Medicare Advantage plan as of 2017, a little lower than the 33 percent average nationwide.

37 percent of Washington Medicare beneficiaries also have a Medicare Part D plan to gain stand-alone prescription drug benefits (to supplement Original Medicare; most Medicare Advantage plans have built-in Part D coverage). This number is much lower than overall percentage of U.S. Medicare beneficiaries who select Part D coverage: 45 percent.

Washington State health insurance resources

State-based healthcare reform legislation

The Washington legislature has been very active in the area of healthcare, addressing numerous issues that impact public health. Scroll to the bottom of this page for a summary of recent Washington bills related to healthcare reform.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.