Washington State is extending the current special enrollment period for purchasing healthcare insurance from May 15 through August 15, 2021. This aligns with the recent federal announcement extending the special enrollment period for those using the federal marketplace. This special enrollment period allows currently uninsured individuals, and people both on and off the Exchange, the opportunity to benefit from these new savings.
The recently passed American Rescue Plan Act significantly increases the amount of tax credits individuals who enroll through Washington Healthplanfinder will receive, which reduces their monthly premiums. The Act also extends tax credits to middle-income Washingtonians who previously were not eligible for assistance and provides additional tax credits to all customers who receive at least one week of unemployment compensation in 2021.
Beginning May 6, new customers who apply through Washington Healthplanfinder will be able to see the amount of increased tax credits available through the new Act. The exact amount premiums will go down depends on where an individual lives, their age, and their income.
Current customers already receiving tax credits should keep their current contact and income information – including unemployment income – up to date in Washington Healthplanfinderto ensure they receive the maximum available benefit. The majority of these customers will not need to take action to receive additional tax credits and will see changes reflected in their June premiums. Customers will receive notification from Washington Healthplanfinderin April if any additional information is needed.
Customers paying premiums over 8.5 percent of their annual income will be eligible for tax credits for the first time if they report their income information. These new tax credits will be reflected in June premiums.
Open enrollment brings more health insurance plans, changing prices.
Washingtonresidents buying health insurance coverage on Healthplanfinder should shop by December 15.
Many Washington residents seeking health insurance coverage on Washington Healthplanfinder will see more options and changing prices when shopping this year.
This is happening because of new market entrants who are offering lower cost plans at all metal tiers. The result is that some residents will see changes to their tax credit as well as the opportunity to find new, lower cost plan options when buying coverage on the state’s marketplace.
Review Plans, You May Find Lower Priced Options
“Given the arrival of new plans to the health insurance landscape, we are encouraging existing customers to review their current options and make sure their plan meets their needs and budget,” explained Chief Marketing Officer Michael Marchland. “The lower priced silver plans mean changes to the tax credit available to qualified customers and this may be reflected in their 2020 premiums.”
Tax credits are calculated based on the premium of the second lowest cost silver plan available to consumers that plan year. This year, new lower priced plans are available in several counties, which means consumers may see a smaller tax credit for 2020 then they had last year. However, this may be offset by the availability of new plans with lower premiums.
The Exchange highly encourages customers to update their information, take advantage of their resources, and shop plans as other affordable options may be available starting November 1. To find the Navigator or broker nearest you: use the WAPlanfinder app or go to Washington Healthplanfinder.
Chat will provide customers a platform to talk directly with customer support representatives—in English and Spanish—during business hours when they are logged into their user account.
Before Starting the Application Process
NOTE: The application process uses your Modified Adjusted Gross Income (MAGI) figure for your household when establishing your entitlement levels and options. MAGI does NOT include workers’ compensation benefits (or Veteran’s benefits, or SSI benefits, and more). See a list of income types that are included and excluded, here, before you begin the application process.
Make sure you’re on the right site: WAHealthplanFinder.org. There are non-governmental sites with VERY similar looking website addresses – don’t be fooled into entering your private information into the wrong site!
If you’re a morning person, get a cup of coffee. If you’re a night owl, get a cup of coffee. Sign into your account each time you go onto the site. If you need to take a break, save your work and it will be there when you later log back in.
Gather all your information:
Legal names of all household members
Birthdates for household members
Home and mailing address
Social Security Number or immigration documents (Families which include unlawfully present immigrants may still apply)
Income information (recent pay stubs, tax return, or W-2)
Tax filing status
Current health plan information
Tribal membership (if enrolled in a federally recognized tribe)
If you already have insurance, take a look at the policies now available before you renew – you may be able to save money or improve your coverage by transferring to a new policy through the exchange. In order to take advantage of subsidies and tax credits, do your shopping through Washington State’s healthcare marketplace. For those that live outside of Washington, your state may have its own healthcare marketplace. If not, or if you’re unsure, start with the federal government’s marketplace site.
2017 coverage –
Are you in need of health insurance for the remainder of 2017? Open Enrollment for 2017 health coverage ended January 31, 2017. You can still get 2017 health insurance two ways:
If you qualify for a Special Enrollment Period due to a life event like losing other coverage, getting married, or having a baby.
The amount you pay for health insurance is based on your household size and income. Workers’ compensation benefits—both time loss and pension – are NOT taxable income. Do not include your time loss or pension payments in your household income figure when applying for health insurance through the exchange or through a Navigator. Veteran’s payments are also excluded from your gross income figure.
The Affordable Care Act is Working!
NY Times Analysis: The Impact of Obamacare, in Four Maps
Since 2013, when the major provisions of Obamacare went into effect, the uninsured rate has fallen in every state. And some states that you might not expect have led the way.
The news about the Affordable Care Act has been grim lately: The price of health plans in new marketplaces is up, and choice is declining in many places. But amid the difficulties, new data highlight the law’s effectiveness in getting coverage for millions of Americans.
Over all, the gains are substantial: a seven-percentage-point drop in the uninsured rate for adults.
While Congress, specifically the House of Representatives, continue to wrangle over funding the Patient Protection and Affordable Care Act (“Obamacare,” to use the pejorative), we here in the “Soviet of Washington” have been quietly taking our own steps towards controlling health care costs. One such step was the establishment of the Washington Health Care Authority (HCA) in 2006. The stated purpose of the HCA is to ensure that the “most comprehensive health care options” are available through state-funded health care plans while “minimizing the financial burden which health care poses on the state.” RCW 41.05.006. The HCA selects different medical technologies for review by the Health Technology Clinical Committee (HTCC)—a panel of physicians and other health care professionals who determine whether those technologies will be covered by state-funded insurance programs.
This complete and utter lack of oversight is troubling…
Sounds like a laudable goal, doesn’t it? Unfortunately, in practice, the committee operates as an unaccountable cabal whose coverage decisions are not subject to any substantive review. When the legislature passed the bill creating the HCA and HTCC, it included a provision for appealing the HTCC’s coverage determinations. But Governor Gregoire vetoed that provision, ostensibly on the belief that other portions of the bill provided sufficient opportunity for review of HTCC coverage decisions. However, as the court of appeals has noted, “there is no statutory procedure for substantively challenging HTCC determinations.” Joy v. Dep’t of Labor & Indus.
This complete and utter lack of oversight is troubling because the HTCC often makes decisions at odds not only with the medical community, but also most other insurance companies.
Recently, the non-partisan Center for Public Integrity ran a story lauding the Washington HCA for “making the tough choice” to implement cost-cutting measures. According to the story, “the Health Technology Assessment . . . reviewed three common, expensive and controversial treatments for chronic back pain: spinal injections, spinal stimulation, a transcutaneous electrical nerve stimulation.” That sentence needs a bit of unpacking. First of all, while relatively common, spinal injections are actually fairly inexpensive and generally considered conservative care. Conversely, while spinal stimulation is expensive, it is comparatively uncommon. But at its essence, the statement from this story is that these treatments are controversial. But are they? Let’s focus first on spinal cord stimulation, for which the HTCC denied coverage on the grounds that it is not safe, medically effective, or cost-effective.
When the HTCC proposes a rule on the coverage or non-coverage of a given health technology, it submits that rule for public comment before publishing the final rule. When it published its findings to the public on spinal cord stimulation, medical practitioners from across the country submitted voluminous literature in support of coverage of spinal cord stimulation—not one medical provider commented that spinal cord stimulation was ineffective or unsafe. One commenter noted that spinal cord stimulation had been used safely and effectively since 1967 to treat intractable back pain without the use of addictive narcotics. The same commenter pointed out that Washington would be the only state to deny coverage of spinal cord stimulation, and that the vast majority of private insurers also cover the procedure.
So why did Washington State decide not to cover spinal cord stimulation? According to the Center for Public Integrity, Josiah Morse, director of the Health Technology Assessment Program, says that the committee “downplays the role of cost in its decisions.” “[I]n most cases there isn’t enough research on the cost-effectiveness of medical technologies, so the committee makes most of its decisions based on safety and effectiveness.” But if no medical professional commented that spinal cord stimulation was unsafe or ineffective, why would the HTCC deny coverage?
Consider another HTCC coverage decision—in 2011, it decided that femoroacetabular impingement (FAI) surgery was not covered. FAI is a condition involving the cartilage of the hip socket. It is extremely painful and, if left untreated, can result in the need for an early hip replacement. FAI surgery is the only solution for moderate to severe cases. The HTCC again requested public comments and again received overwhelming support for coverage of FAI surgery. In fact, the only comment not urging coverage came from Josiah Morse, who urged his own committee “to bullet, bold or otherwise call out the last sentence that no cost, cost-effectiveness data were found.” It seems inappropriate for Mr. Morse to emphasize a lack of data to his own committee as a reason to deny coverage of the surgery—especially when it is his committee that is entrusted to gather the data in the first place.
The Washington Health Care Authority must be held accountable to the people of Washington State. Skyrocketing costs are obviously of great concern to anyone interested in healthcare reform, but costs alone cannot be the sole, or even dominant, ground upon which to base a healthcare benefit coverage determination. I, for one, am not comfortable living in a world where decisions about whether or not my insurance company will cover an expensive, life-saving or –altering procedure are based predominantly on the cost of the procedure.
 A quote attributed to Postmaster General James Farley in 1937.
 Joe Eaton, The Other Washington Could Hold the Key to Medicare’s Cost Crisis, The Center for Public Integrity (July 29, 2013).