Last week, amid uncertainty about the future of the ACA, Washington State’s Health Benefit Exchange Board certified health and dental plans for 2018. Over 180,000 individuals who purchase coverage through the Exchange will see an average 24 percent increase over this year’s rates, though many will qualify for federally-provided tax credits that help lower the cost of monthly health insurance premiums. (The tax credits that reduce the cost of monthly premiums are different than the hotly debated cost-sharing reductions that reduce out-of-pocket costs for consumers.) Since the future of cost-sharing reductions remains unclear, a set of higher rates were also approved that they will be allowed to charge if the cost-sharing reductions are eliminated.  These higher rates reflect the cost associated with the carriers assuming payment of the out-of-pocket costs. Open enrollment begins on November 1.