Featured Policy Priorities

Promoting Care and Continuity of Coverage

In 2017, more than 1.7 million Washingtonians are enrolled in health coverage, many for the first time, through Medicaid and Affordable Care Act programs.  Beginning in January 2014, the Affordable Care Act allowed Washington State to expand significantly the Medicaid program (now called Apple Health) and to begin offering Qualified Health Plans (QHPs) through the Washington Health Benefit Exchange (HBE), an online health insurance marketplace.

A family's income determines whether they enroll in Apple Health or a QHP. When income or other circumstances change, people may transition from one coverage type to another or lose coverage altogether. These individuals must have uninterrupted access to the health plan they prefer and the doctors they trust. That requires simple and seamless transitions between programs. Refinements to the system and increased coordination between state agencies and HBE are needed to avoid "churn" - harmful and costly disruptions in care and coverage.

One area of specific concern relates to women enrolled in a Qualified Health Plan who become pregnant and may elect to enroll Apple Health for Pregnant Women coverage based on income. This could result in disruptions in care referred to as "pregnancy churn." An example of this is losing access to the person’s care providers because they do not have a contract with the newly-assigned Apple Health managed care plan.  Pregnant women may be eligible for Apple Health for Pregnant Women coverage if their income is under 198% of the federal poverty level. Read our issue brief on pregnancy churn to learn how this could affect your care and what you can do to prevent or address potential disruptions.  

NoHLA continues to be concerned about people who experience churn, which can occur in a variety of situations.  Some examples are people moving from Apple Health to QHPs, and people with employment status changes.

Publications & Reports

Recent Publications

NoHLA's 2017 comparison of  provisions in the House and Senate budget bills that relate to health care access.

NoHLA's Summary of the Health Care Access Bills from 2017

Recent Reports

Consumer-Centric Considerations for Integration

This document was developed by the Low Income Populations (LIP) committee of the Healthy Washington Coalition (HWC), a broad-based coalition of organizations dedicated to ensuring that Washington State has quality, affordable health care coverage for all of its residents. The purpose of this document is to highlight the perspective of consumers within discussions about how physical, behavioral, and oral health can best be integrated. 

Read more here.

NoHLA - OneAmerica Report Urges Consumer Reforms at Yakima Regional and Toppenish Hospitals

A new report from NoHLA and OneAmerica highlights the need for Yakima Regional and Toppenish hospitals to ensure that patients who qualify for financial assistance actually receive it.

Read more here.

NoHLA and Washington CAN Issue Report and Recommendations on Consumer Involvement in Regional Decisionmaking

Washington recently established Accountable Communities of Health in each of nine regions of the state for purposes of health system decision-making. These “ACHs” offer a watershed opportunity to actively include members of communities that experience disparities in health outcomes and access to care in making these decisions.

Read more here.

Contraceptive Coverage in Washington State's Qualified Health Plans

A new report came out April 2015 authored by Northwest Health Law Advocates, with assistance from NARAL Pro-Choice Washington, examines whether insurance companies selling health plans through the online marketplace, Washington Healthplanfinder, are complying with the ACA's contraceptive coverage requirement.

Read more here.

Improving Transparency in Insurance Decisions

NoHLA's new "Report and Recommendations on Washington State's Independent Review System" recommends improvements in the system for collecting, analyzing, and making publicly available the decisions issued by Independent Review Organizations when consumers appeal a denial of health insurance coverage.

Read more here.

NoHLA Survey of Health Care Navigators and Assisters Identifies Issues that Need Attention

In September 2015, NoHLA conducted its second annual online survey of the navigators and assisters who help Washington residents apply for health coverage. In total, the 64 respondents, representing all of Washington's 39 counties, assisted approximately 81,000 individuals between October 2014 and September 2015.

"While we are pleased that the first two years of Affordable Care Act implementation has sharply reduced the number of uninsured in our state, this survey indicates that obstacles remain which must be addressed," Janet Varon, Executive Director of NoHLA observed. NoHLA will use the survey results to guide its advocacy in the coming year.

Read more here.

Language Access in Washington State Under the Patient Protection & Affordable Care Act

Read more here.

Key Resources

Legislative & Budget Action in Washington State

Includes summaries of the most recent Legislative session, and updates when session is in progress. Click here for the latest Legislative and Budget Action.

Health Coverage Information

Health Coverage Options in Washington State - NoHLA's summary of the options for Washington's residents who need health options or assistance with medical costs.

Individual Health Insurance in Washington State

The 2017 HHS poverty guidelines

Summary of Major Health Care Authority Medical Program Categories and Subsidized Insurance in Washington State – as of November 11, 2016 - designed for specialist familiar with public programs. Includes WAC citations.