The Washington Health Benefit Exchange is Open for Business

Richard Smaby
On Sept. 4 the City Club of Tacoma hosted a presentation on the Washington Health Benefit Exchange. The exchange’s website and telephone lines are open for business. Michael Marchand, Director of Communications, Washington Health Benefit Exchange, talked about the background and current status of the exchange, specifically the Washington Healthplanfinder. Beth Wilson, Program Coordinator for Maternal Child Health, Tacoma Pierce County Health Department, described their efforts to reach people who are eligible for the exchange. The presentations were timely, since the enrollment period extends from Oct. 1 to Mar. 31. It is time to find out whether there is a plan for you or someone you know.

Michael Marchand said they expect hundreds of thousands of people to inquire about the exchange. They received 900 calls on day one of their operation. Washington State is a leader in the implementation of a state health benefit exchange. The state got on board in May 2011, when then Governor Gregoire approved SB5445 passed the previous month by the legislature. The exchange is a public-private partnership. It was designed through extensive and detailed feedback from stakeholders. The exchange consists of a board with 9 members picked by a committee composed of Democrats and Republicans. In addition, there are dozens of committees: Consumer Workgroup, Outreach Workgroup, Dental Plan Technical Advisory Committee, etc.

Private health insurers apply to the exchange to qualify to offer their plans. If their plans are approved, citizens of Washington State can choose among the plans of a number of companies. The federal government is looking to Washington State and a few other states for guidance on how to implement exchanges. Since the federal government is providing $151 million to the state to develop the program, the state must initially provide what they develop to others for free. But when federal funding is finished, the state can charge for services and code they provide to other states.

The online implementation of access to the exchange is key to connecting people to their options. One yardstick of progress is the amount of time it takes to determine Medicaid eligibility. It used to take 45 days to determine if someone qualified for financial assistance. Now it takes 5 to 10 minutes.

However, the hardest thing in getting people insured is not technical issues, not politics, not information, but changing people’s behavior. Market research shows that people generally want health insurance, but they don’t know where to find it. There are some people, young people especially, who think they don’t need health insurance – until they do! There are a lot of people out there who are desperate for affordable health insurance. The exchange is concerned about how to meet the demand.

Marchand said that the people attending his presentation at the City Club will probably not use the exchange. However, the degree of separation from the people there and someone who needs the exchange is one; everyone in the room knows someone who can benefit from the exchange. However, there is a way the Affordable Care Act benefits each of us – cutting down on health care visits that are not paid for. 14% of Washington residents are uninsured, not including illegal aliens. Uncompensated health care in Washington State is in the range of 1 to 1.3 billion dollars per year. Those of us with healthcare insurance pay this bill with higher health insurance premiums.

Beth Wilson continued the presentation with a focus on what the Tacoma Pierce County Health Department is doing to reach out to Pierce County residents. 

109,000 Pierce County residents do not have health insurance. 54% of them are estimated to be eligible for the Medicaid expansion. 80% are eligible for tax credits to reduce their cost for health insurance. But many are not computer literate or have no easy access to a computer. Some don’t speak English well enough to use the online resources. 25% will need extra help. The federal and state governments are funding in-person assisters, who travel to the homes of those who are not able to complete the process of signing up for health insurance or other support they are entitled to. There are paid partners who provide assistance, such as South Sound Outreach. Eatonville Family Agency is another.  

If you want more information for yourself or to assist others, the following sites are useful.

Be careful to not confuse washingtonhealthplanfinder.org with the above. It is not the official exchange site. See an article in The Seattle Times.