What is the Exchange?

Washington Health Benefit Exchange (Exchange) works hard to redefine how Washington residents secure health insurance through innovative and practical solutions, an easy-to-use customer experience, equity, transparency and by providing undeniable value to the health care community.

A health benefit exchange is a key provision of the Affordable Care Act that created a marketplace for each state to offer health and dental insurance to people and their families. Exchanges can be developed and implemented by the state or by the U.S. Department of Health and Human Services. Washington state chose to implement a state-based exchange.

The Exchange initially started as part of Washington State Health Care Authority and has since transitioned to an independent organization. We continue to work closely with our state agency partners, including the Health Care Authority, Office of the Insurance Commissioner, and the Department of Social and Health Services.

A public-private partnership

The Exchange was established by the Washington State Legislature in 2011 as a public-private partnership that operates Washington Healthplanfinder, the state’s online eligibility and enrollment portal for both Washington Apple Health and qualified health plans (QHPs).

The Exchange is governed by an 11-member bipartisan board comprised of a chair and eight voting members. Board members are nominated by the Republican and Democratic caucuses in both the Washington State House of Representatives and Senate and are appointed by the governor. The Washington State Insurance Commissioner and Health Care Authority Director serve as ex officio, non-voting members. The Exchange complies with open public meetings and public disclosure guidelines but is not subject to other laws that govern state agencies.

Our collective efforts have led to a profound reduction the state’s uninsured rate, which dropped from more than 14% in 2013 to less than 5% in 2023.

Exchange budget

The Exchange budget is appropriated by the Legislature. Required by the Legislature to be self-sustaining, the Exchange must be, as defined in statute, “capable of operating with revenue attributable to the operations of the Exchange.” Current revenue sources include the existing 2% premium tax on health insurance premiums for QHPs sold through Washington Healthplanfinder; a carrier assessment on products sold in the marketplace; and state and federal funds to reimburse for Apple Health activities.

A focus on affordability

Cascade Care aims to make health insurance accessible and affordable for every Washington Healthplanfinder customer. Standard plans, marketed as Cascade (standard) and Cascade Select (public option), as well as Cascade Care Savings (state premium assistance program) work in tandem with premium tax credits to reduce health care costs for many Washington Healthplanfinder customers.