Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
HB 2340
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
Brief Description: Addressing the Washington state health insurance pool.
Sponsors: Representatives Schmick, Cody and Jinkins.
Brief Summary of Bill |
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Hearing Date: 1/13/16
Staff: Ariele Landstrom (786-7190).
Background:
The Washington State Health Insurance Pool (WSHIP) is the high risk health insurance pool for Washington. The WSHIP is an independent, nonprofit entity created by legislation. The WSHIP provides coverage for individuals who are unable to obtain comprehensive health coverage or Medicare supplemental coverage. The WSHIP offers two types of plans; non-Medicare eligible plans and Medicare-eligible plans.
To be eligible for coverage under a WSHIP non-Medicare plan, an individual must be a Washington resident and not be eligible for:
Medicare coverage, and enrolled in a WSHIP non-Medicare plan prior to December 31, 2013; or
Medicare or Medicaid, and residing in a county where an individual health plan is not offered to the individual.
The WSHIP has been closed to new non-Medicare enrollment because individual plans were offered in all counties in 2014 and 2015. The WSHIP must discontinue all non-Medicare plans on December 31, 2017.
The WSHIP Medicare-eligible plan remains open to enrollees who are unable to obtain comprehensive supplemental coverage or a Medicare Part C plan with no discontinuation date.
In 2012, the WSHIP completed a study to review whether populations needed ongoing access to coverage through the WSHIP, with specific attention to those persons who may have been excluded from or received inadequate coverage beginning January 1, 2014. Legislation enacted in 2013 required the WSHIP to revisit the study of eligibility and complete another review of populations that may need ongoing access to coverage through the WSHIP by November 1, 2015. The requirements of the study were to:
include both the non-Medicare populations scheduled to lose coverage and Medicare populations, including whether the enrollees have access to comprehensive coverage alternatives that include appropriate pharmacy coverage;
address any barriers to eligibility that remain in accessing other coverage such as Medicare supplemental coverage or comprehensive pharmacy coverage; and
suggest any financing changes and recommend a future expiration of the pool.
In 2015, the WSHIP issued the following recommendations:
continue WSHIP non-Medicare coverage beyond December 31, 2017;
continue WSHIP Medicare coverage;
maintain the WSHIP funding mechanism; and
expand alien medical coverage for undocumented immigrants by expanding the Alien Medical for Dialysis and Cancer Treatment program to cover other serious medical conditions and post-transplant care.
Summary of Bill:
The WSHIP non-Medicare plans are no longer discontinued effective December 31, 2017.
In addition to existing categories of eligibility for the non-Medicare plans, any resident of the state is eligible for WSHIP coverage if he or she is (1) not eligible for Medicaid or Medicare coverage and (2) not eligible to purchase a health plan through the Washington health benefit exchange.
Appropriation: None.
Fiscal Note: Requested on January 6, 2016.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.