The Washington Health Benefit Exchange will have a $110 million budget to operate Healthplanfinder, the online exchange selling individual insurance coverage and plans for small businesses. The exchange had asked the state for $127 million.
Washington’s health-insurance exchange will have to figure out how to get by on less money from the state than it hoped for over the next two years, but officials Wednesday said the budget is “sufficient.”
Over the 2015-17 biennium, the Washington Health Benefit Exchange will have a $110 million budget to operate Healthplanfinder, the online exchange selling individual insurance coverage and plans for small businesses. The website is also where people enroll in Medicaid.
The exchange had asked the state for $127 million, plus $20 million in federal grants it already has received.
“This funding level will provide sufficient resources to run our marketplace,” Richard Onizuka, chief executive of the exchange said in a statement.
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He said the budget, part of the state operating budget that Gov. Jay Inslee signed late Tuesday, will require the exchange’s governing board and staff to make some decisions and establish priorities in such areas as customer service and system upgrades. “These decisions will be critical as the exchange moves from federal grants to a sustainable business model that includes state funds,” Onizuka said.
Roughly 170,000 people have private-insurance coverage through Healthplanfinder, which is more than 40,000 people short of the exchange’s goal for this year.
It’s not clear where the budget cuts will come from, but past conversations have looked at reducing the staff at the call center that helps customers and brokers resolve enrollment problems, fewer or no improvements to the Healthplanfinder website, longer wait times for the resolution of customer problems, and less outreach and education.
Washington has three main sources to fund the exchange locally.
First, all health-insurance premiums in Washington include a 2 percent state tax, and the revenue collected on exchange plans goes back to Healthplanfinder.
Second, because Healthplanfinder is also the site for Medicaid enrollment, the exchange is reimbursed for those services with state and federal Medicaid dollars.
Third, the exchange charges insurance companies a per-month, per-person assessment fee for everyone receiving insurance through the state’s website.
With the lower-than-hoped-for enrollment numbers, the three revenue streams came to about $101 million.
The assessment fee was $4.19 for plans this year, and will almost certainly increase for 2016 plans.
A spokeswoman with the exchange said Wednesday that the updated assessment fee will be set over the next couple of weeks.