Cascade Care Subsidy Study

Senate Bill 5526 (2019) directed the Exchange to develop and submit a plan for implementing state premium subsidies for Washington Healthplanfinder customers with incomes up to 500% of the Federal Poverty Level (FPL). The Exchange submitted its report, including an implementation plan, recommendations, and corresponding draft legislation, to the Legislature on November 15, 2020. The report, utilizing an interactive subsidy model developed by Wakely, analyzes the impacts for multiple methods of delivering a state premium subsidy at varying levels of financial assistance. The report also includes an analysis of tying a state subsidy to the purchase of a Cascade Care health plan, additional cost-sharing reduction subsidies, and financing mechanisms that were considered for funding a state subsidy program. The implementation plan is intended to inform legislative work during the 2021 legislative session, leading towards a Washington state subsidy program beginning as early as January of 2023.

The state subsidy report and implementation plan, as well as analysis of other state subsidy programs, available data from the Exchange’s subsidy modeling, and other research that went into the report, can be found on the Exchange’s Legislative Reports page.

Scalable state premium subsidies would complement available federal premium subsidies, particularly for gap populations not receiving any federal assistance and individuals who face affordability barriers even after receiving extra federal help. Wakely, using the subsidy model described above, also did a separate analysis of the impact of the American Rescue Plan Act (ARPA) in Washington state that can be found on Wakely’s website.