Featured Policy Priorities

Promoting Care and Continuity of Coverage

In 2014, more than 600,000 Washingtonians enrolled in health coverage, many for the first time, due to the Affordable Care Act. Washington State greatly expanded the Medicaid program (now called Apple Health) and began 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." 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 more about short-term and long-term solutions Washington State could advance in this area. NoHLA is seeking to reduce churn in a variety of situations, including people moving from Apple Health to QHPs, and those who have changes in employment status.

Federal Basic Health Program

Health care reform gives states new options to expand health coverage, such as the "Federal Basic Health Program." Federal regulations for this program were adopted in March 2014 to take effect January 1, 2015. Some states are now in the planning stages or considering the feasibility of adopting this option. Read this fact sheet on the Federal Basic Health Option to learn why it is the best way to increase coverage options for lower-income residents in our state. NoHLA continues to work toward adoption of a Federal Basic Health Program in Washington.

Publications & Reports

Recent Publications

NoHLA's Summary of the 2015-17 Washington State budget - Health Care Access

NoHLA's Summary of the Health Care Access Bills from 2015

Recent Reports

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

2015 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 2014 HHS poverty guidelines (or click here for PDF)

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.