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.

Surprise Billing

Nearly 1 in 3 Washingtonians received a surprise medical bill in the past two years, according to a new Consumer Reports Survey. To protect consumers from surprise billing, NoHLA is teaming up with the Consumers Union to support House Bill 2447, a measure requested by state Insurance Commissioner Mike Kreidler.

Read more here.