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Dear Friends and Neighbors,

The Affordable Care Act is legislation that passed the United States’ Congress in 2010. Some know it as Obamacare. For the purpose of this e-mail update, we will just call it federal health care reform.

At the end of 2013, some major provisions of federal health care reform were implemented at the state level. One of those provisions are Exchanges. Exchanges are online marketplaces that allow people to compare and buy health insurance plans, and find out if they qualify for a government subsidy. Each state was given the option of creating their own Exchange. Only 14 states chose this option – including Washington state. Our state established the Washington Health Benefit Exchange through Senate Bill 5445 in 2011 and House Bill 2319 in 2012.

We’ve all heard about the problems with federal health care reform at the national level. Unfortunately, many of those problems are happening here in our state. For example, 290,000 Washingtonians in the individual market received cancellation notices. We have also seen website problems, tax-credit miscalculations, calls going unanswered at the Exchange customer-support center, and families losing important network coverage. Many individuals, families and small businesses are also experiencing sticker shock with new health care costs.

We are very much on the front end of implementing federal health care reform. It still has other major provisions that need to be determined. For example, the employer mandate. The employer mandate, which was delayed by the Obama Administration, will require businesses with 50+ full-time equivalent employees to offer government-approved health insurance plans to their employees or else pay new federal taxes. Employers still don’t know what the final rules for the employer mandate will be. In a fragile economy, you can imagine the uncertainty this is causing for many businesses in our state.

Washington Health Benefit Exchange — by the numbers

Who is signing up for our state’s Exchange? Here is a breakdown (as of January 9):

  • Of the 454,009 that have completed health insurance plan enrollments using the Exchange, 380,911 are Medicaid.
    • The federal government will pay 100 percent of the cost for this new population through 2016. In 2017, the state will begin paying a portion of the costs – 5 percent in 2017, 6 percent in 2018, 7 percent in 2019, and 10 percent in 2020 and beyond.
  • Of the 454,009 that have completed health insurance plan enrollments using the Exchange, only 73,098 are for non-Medicaid health insurance plans. It was estimated that 130,000 individuals would enroll in non-Medicaid health insurance plans by January 1, 2014.
  • Of the 73,098 non-Medicaid health insurance plans noted above:
    o    56,285 will receive a tax credit/subsidy (i.e. taxpayer-funded subsidy).
    o    Only 16,813 individuals have purchased a “full-price” health insurance plan on the Exchange.

Will projections match reality?

Aside from the affect federal health care reform will have on individuals, families and employers, these Exchange numbers worry me as a state lawmaker. When you look at the imbalance of people who will receive Medicaid or some other tax credit/subsidy, and people who will be paying “full-price” for their health insurance plans, I’m concerned about the immediate costs to our federal government and the future costs to our state government – beginning in 2017. One of the problems is that it does not appear that young people are signing up for our Exchange. If projections don’t end up matching reality, the system could collapse on top of itself. We will need to continue to monitor Exchange numbers carefully and react accordingly.

Additional information

Please share your health insurance story with me

If you’ve had a negative experience with the new federal health care reform, or a positive one, please share your story with me. Feel free to e-mail me or call me.


In your service,

Dan Kristiansen

State Representative Dan Kristiansen, 39th Legislative District
426A Legislative Building | P.O. Box 40600 | Olympia, WA 98504-0600
(360) 786-7967 | Toll-free: (800) 562-6000