Health Care Reform Resource Center

December Update:

Helpful Health Insurance Enrollment Tips from Washington Health Benefit Exchange 

  1. You can enroll through March 31, 2014 if you don’t need coverage starting Jan. 1. Current Medicaid subscribers who have been notified that their annual review is due must also visit Washington Healthplanfinder and verify their eligibility before the end of 2013 to continue their coverage after Jan. 1. 
  2. Find an Insurance Agent or Broker: The toll-free Customer Support Center at 1-855-WAFINDER has doubled staff since mid-September, but is still experiencing high call volumes. In-person help is also available on to help with sign-up:  “Find a Broker” or “Find a Navigator
  3. Enroll Online: Complete an application online at wahealthplanfinder.org for a faster eligibility determination. If you’ve encountered an issue when completing an application online, do not complete a paper application. Instead, revisit your account periodically as staff continue to make nightly corrections and updates to address any errors.
  4. Attend an Enrollment Event: Community groups and partners are organizing outreach and awareness events across the state. To find an event in your area, go to: http://www.wahbexchange.org/get-involved/community-events/
  5. Use Helpful Tips: For answers to frequently asked questions and tips to address hurdles you may face in completing an application, Washington Healthplanfinder has created an “Application Tips” webpage: http://www.wahbexchange.org/news-resources/healthplanfinder-status-updates/healthplanfinder-quick-tips/ .

Medicaid Note: Washington Apple Health (Medicaid) does not have an open enrollment period.  Individuals and families will be able to apply and complete their renewals via www.wahealthplanfinder.org throughout the year. Questions about Healthplanfinder should be directed to the toll-free Customer Support Center at 1-855-WAFINDER; Apple Health questions can be directed to the toll-free hot line at 1-800-562-3022 or emailed to AskMedicaid@hca.wa.gov.


Over the course of health care reform, I have told the stories of thousands of Washingtonians who have shared their health care needs with me.  I have heard from all corners of the state.  From those with health insurance and from those without.  From men and women who have struggled to pay premiums for their families.  From small business owners who were fighting to cover their employees.   And from people who couldn’t get coverage at all due to a pre-existing condition.   

Health Care Reform Resource Center

Ensuring that everyone can have access to quality, affordable health care is one of the most critical challenges facing our nation.  For three years, Washingtonians have benefited from better access and a health care system that it is working for them and not just for those who can afford it.  I will continue to work with my colleagues in the Senate to improve health care quality and coverage for all Washingtonians and all Americans as we implement the Affordable Care Act.


Since its passage on March 23, 2010, the Affordable Care Act has allowed Washington state families and small business owners the ability to benefit from better access, more choices, and a health care system that no longer works only for those who can afford it. 

Some of these benefits include:


Creating Affordable Health Insurance Marketplaces

The Affordable Care Act will expand health insurance coverage by establishing a Health Insurance Marketplace in every state and increasing access to the Medicaid program.  The Marketplace is a new way to shop for health insurance that fits your budget and needs.  By filling out one application, you can see a variety of different options and enroll in the plan that is best for you.  By using the Marketplace, you can also find out if you qualify for financial assistance to help you pay for health insurance premiums and copays. In Washington state, over 750,000 residents may qualify for tax credits to help them purchase insurance in the Marketplace or for Medicaid coverage.

Starting this fall, individuals in Washington will be able to shop for health insurance and compare plans through the Marketplace.  The Marketplace is designed to help you find health insurance that fits your budget, with less hassle.  Every health insurance plan in the new Marketplace will offer comprehensive coverage, from doctors to medications to hospital visits. You can compare all your insurance options based on price, benefits, quality, and other features that may be important to you, in plain language that makes sense.

Washington Healthplanfinder

Beginning on October 1, 2013, Washingtonians will be able to find, compare, and enroll in affordable health insurance plans through Washington Healthplanfinder.

Through Washington Healthplanfinder, you will be able to:

  • Compare health insurance plans side by side to find the one that is best for you.  You can sort plans by cost, coverage, provider, or other factors to help you choose the right plan.
  • Find financial help to pay for copays and premiums.  Washington Healthplanfinder can determine if you are eligible for financiaCalculatorl assistance to pay for copays and premiums based on your age, annual income, and household size.  You can use this calculator to find out how much your health insurance might cost and if you might be eligible for financial assistance.
  • Select and enroll in a health insurance plan.  You can browse and learn more about the different plans that are available, then enter basic information to begin the application process. 

Washington Healthplanfinder will be ready for open enrollment on October 1, 2013.

HealthCare.gov

You can visit HealthCare.gov to prepare for the Marketplace before open enrollment begins on October 1, 2013.  HealthCare.gov was launched to help HealthCare.govindividuals have more control over their health care as informed and empowered consumers.  This new site and 24-hour call center will help you understand your choices, prepare for open enrollment, and sign up for the health insurance coverage that best suits your needs.   You can access educational information and learn what you can do to begin to get ready for open enrollment this fall.

HealthCare.gov will help you get ready to enroll in the Marketplace:

You can also obtain information and assistance through the Marketplace Call Center at 1-800-318-2596.  The 24-hour call center provides assistance in English, Spanish, and over 150 additional languages.  Hearing impaired individuals using TTY/TDD technology can dial 1-855-889-4325 for assistance.

El 1 de octubre comienza una manera nueva de obtener cobertura médica de calidad.  Hispanohablantes deben visitar CuidadoDeSalud.gov para aprender más de los mercados de seguros médicos. 


Assistance for Small Businesses

The Affordable Care Act provides employers who have small businesses with fewer than 25 employees and provide health insurance to their employees the ability to qualify for a tax credit of up to 35 percent (up to 25 percent for non-profits) to offset the cost of insurance. This credit will increase in 2014 to 50 percent (35 percent for non-profits).


Expanding Coverage Options for Young Adults

Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family’s coverage.  Thanks to this provision, over 62,000 young adults in Washington state have already gained insurance coverage as a result of the health care law.


Making Prescription Drugs Affordable for Seniors

Medicare beneficiaries in Washington have saved over $94.9 million on prescription drugs since the law’s enactment.  In 2010, Medicare beneficiaries who hit the coverage gap or “donut hole” in the

Medicare prescription drug benefit received a one-time $250 rebate.  In 2011, Medicare beneficiaries began receiving a 50 percent discount on covered brand name drugs and coverage for 7 percent of the cost of generic drugs in the coverage gap.  In 2013, Part D covers 21 percent of the cost of generic drugs in the coverage gap.  Coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will be closed.

  • Learn more about Medicare prescription drug coverage.
  • If you have any questions regarding potential discounts and rebates, you should call Medicare's toll-free number at 1-800 MEDICARE (1-800-633-4227) or TTY 1-877-486-2048.

Covering Preventive Services with No Deductible or Co-pay

Insurance companies are now required to provide certain preventive services without requiring a copayment, co-insurance, or deductible to receive recommended preventive health services.  Additionally, over 1 million women in Washington now have guaranteed access to additional preventive services without cost-sharing.


Removing Lifetime Limits on Health Benefits

The law bans insurance companies from imposing lifetime dollar limits on essential health benefits.  Starting in 2014, yearly dollar limits on coverage will also be banned.


Creating New Coverage Options for Individuals with Pre-existing Conditions 

Starting in 2014, many individuals with pre-existing conditions will no longer be refused coverage or charged more for their coverage, even if they have been refused coverage due to a pre-existing condition in the past.


Providing Better Value for Your Premium Dollar

Insurance companies must spend generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing.  If they do not, they must provide consumers a rebate or reduce premiums.  7,681 Washington residents with private insurance coverage will benefit from $594,031 in rebates from insurance companies this year, for an average rebate of $185 per family covered by a policy.


Scrutinizing Unreasonable Premium Increases

Insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more.


Preventing Illness and Promoting Health 

The Prevention and Public Health Fund was created to support effective policies in Washington state, its communities, and nationwide so that all Americans can lead longer, more productive lives.  Since 2010, Washington state has received over $21.7 million in grants from the Prevention and Public Health Fund.


Increasing Support for Community Health Centers

The law increases funding for community health centers in all 50 states, including the 243 existing community health centers in Washington.  Community Health Centers in Washington have received over $117 million under the Affordable Care Act to support ongoing health center operations, establish new sites, and expand services.  Community health centers in Washington provide preventive and primary health services to 794,485 people.  If you cannot afford a health insurance plan, you can get free or low-cost health and dental care at a community health center.


Links to Full Health Care Reform Law