Washington Health Benefit Exchange budget and policy update

In late April, the Washington State Legislature passed an operating budget for next biennium (July 1, 2025, through June 30, 2027) and adjourned its regular session for the year. Yesterday, Gov. Bob Ferguson signed that budget. Below is a synopsis of what both the recent budget and policy actions mean for Washington Health Benefit Exchange and Washington Healthplanfinder customers. 

Ultimately, in a very difficult state fiscal environment, most Exchange priorities and highest priority operational budget increases were funded. We are grateful to the Legislature and governor for their work and for our budget wins. Notably, Cascade Care Savings, the state’s premium assistance program, is funded for another plan year. 

Budget highlights

• Cascade Care Savings is funded for plan year 2026 at $55 million. We will revisit this issue again with the legislature next year for funding for plan year 2027. The Cascade Care Savings contingency plan is still in place, and we will not be offering it before open enrollment begins. 
• Funding is continued over the next two years for important Washington Healthplanfinder improvements. These include critical capacity for the Exchange development efforts and are vital amid federal and state changes that affect Washington Healthplanfinder.
• Our request to expand language access for Washington Healthplanfinder customers was funded. This will help us begin the process to expand our core languages from eight to 16.
• Two other initiatives were funded for Exchange work in the next two years:
  • Washington Healthplanfinder currently enrolls people under the age of 65 into Medicaid based on their modified adjusted gross income (MAGI). Development work in Washington Healthplanfinder to serve as the eligibility and enrollment tool for non-MAGI Medicaid clients (note this appropriation is dependent on Centers for Medicare & Medicaid Services [CMS] approval of the substantial federal funding required for implementation); and
  • Beginning Jan. 1, 2027, commence development work for facilitated enrollment capability in Washington Healthplanfinder. Completion of this work would need to be funded in the next biennial budget.
• A proviso for a state only program for immigrant health care was funded in anticipation of CMS withdrawing the state’s Sec. 1332 waiver. This enables the Exchange to create a state-only program to serve impacted customers.

Policy highlights – Bills that passed

A number of bills passed this session that aim to address cost containment and transparency, which is also a priority for the Health Care Cost Transparency Board. Those include:

• 5083: Establish a reference-based pricing model for Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) plans. This model sets limits on hospital inpatient and outpatient services, along with minimum levels for primary care and behavioral health.
• 1686: Create a health care entity registry. This bill requires Washington State Department of Health to develop, plan and provide recommendations to the Legislature on how to create a comprehensive and user-friendly registry of health care entities in Washington.
• 5084: Carriers’ primary care expenditure reporting. The Office of the Insurance Commissioner may require carriers to annually report primary care expenditures in the previous or upcoming calendar year.  

Bill focused specifically on the Exchange

• 5077: Expand voter registration services by government agencies. Subject to approval by CMS, this bill allows the Exchange to decide to implement an “opt out” voter registration process. The Exchange is still able to use its existing “opt in” voter registration process. It also allows the governor to decide if other agencies should implement an “opt out” voter registration process.

Next steps

Now that the session is over and the governor has signed the budget, the Exchange will continue to work to create conditions, policies and practices that allow for Washingtonians to access and afford health insurance that works for them and their families. The Exchange is grateful to the many policy makers, advocates, elected officials and community leaders who support our mission to radically improve how Washington residents secure health insurance through innovative and practical solutions.