Vetoed by Governor Chris Gregoire

Vote Smart's Synopsis:

Vote to concur with Senate amendments and pass a bill that establishes specific rules for the Washington health benefit exchange.

Highlights:

• Establishes the Washington Health Benefit Exchange as a "self-sustaining" public-private partnership separate and distinct from the state (Sec. 3).

• Defines “self-sustaining” as capable of operating without a direct state tax subsidy (Sec. 2).

• Requires the exchange to open enrollment to various qualified health plans beginning October 1, 2013 (Sec. 4).

• Authorizes the Washington Health Benefit Exchange to establish procedures allowing governments, Native American tribes, and private foundations to pay premiums on the behalf of certain qualified individuals (Sec. 4).

• Requires carriers offering "bronze plans" for individual or small group health insurance outside of the exchange to offer "silver" and "gold" plans as well (Sec. 6).

• Defines “bronze plans” as plans that provide coverage roughly equivalent to 60 percent of the benefits provided under the plan (Sec. 6).

• Defines “silver plans” as plans that provide coverage roughly equivalent to 70 percent of the benefits provided under the plan (Sec. 6).

• Defines “gold plans” as plans that provide coverage roughly equivalent to 80 percent of the benefits provided under the plan (Sec. 6).

• Specifies that a "catastrophic health plan" may only be sold through the exchange (Sec. 6).

• Defines “catastrophic health plan” as a plan that requires a yearly deductible of $1,750 and an annual out-of-pocket maximum of $3,500 for a single enrollee, to be adjusted annually (Sec. 1).

• Specifies that a plan will be certified as a qualified health plan to be offered through the exchange if the plan meets the following criteria (Sec. 8):
• The insurance commissioner determines that the plan meets legal requirements;
• The board of the exchange determines that the plan meets legal requirements; and
• The plan includes rural and urban Native American clinics as community providers in a way that is consistent with federal law.

• Requires the board of the exchange to establish a rating system to assist customers in choosing a plan offered within the exchange (Sec. 9).

• Requires the rating system to incorporate certain criteria including, but not limited to, the following (Sec. 9):
• Affordability;
• Enrollee satisfaction; and
• Coverage of spiritual care services.

• Requires the operations of the Washington Health Benefit Exchange to be suspended if the exchange ceases to be self-sustaining (Sec. 26).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that establishes specific rules for the Washington health benefit exchange.

Highlights:

• Establishes the Washington Health Benefit Exchange as a "self-sustaining" public-private partnership separate and distinct from the state (Sec. 3).

• Defines “self-sustaining” as capable of operating without a direct state tax subsidy (Sec. 2).

• Requires the exchange to open enrollment to various qualified health plans beginning October 1, 2013 (Sec. 4).

• Authorizes the Washington Health Benefit Exchange to establish procedures allowing governments, Native American tribes, and private foundations to pay premiums on the behalf of certain qualified individuals (Sec. 4).

• Requires carriers offering "bronze plans" for individual or small group health insurance outside of the exchange to offer "silver" and "gold" plans as well (Sec. 6).

• Defines “bronze plans” as plans that provide coverage roughly equivalent to 60 percent of the benefits provided under the plan (Sec. 6).

• Defines “silver plans” as plans that provide coverage roughly equivalent to 70 percent of the benefits provided under the plan (Sec. 6).

• Defines “gold plans” as plans that provide coverage roughly equivalent to 80 percent of the benefits provided under the plan (Sec. 6).

• Specifies that a "catastrophic health plan" may only be sold through the exchange (Sec. 6).

• Defines “catastrophic health plan” as a plan that requires a yearly deductible of $1,750 and an annual out-of-pocket maximum of $3,500 for a single enrollee, to be adjusted annually (Sec. 1).

• Specifies that a plan will be certified as a qualified health plan to be offered through the exchange if the plan meets the following criteria (Sec. 8):
• The insurance commissioner determines that the plan meets legal requirements;
• The board of the exchange determines that the plan meets legal requirements; and
• The plan includes rural and urban Native American clinics as community providers in a way that is consistent with federal law.

• Requires the board of the exchange to establish a rating system to assist customers in choosing a plan offered within the exchange (Sec. 9).

• Requires the rating system to incorporate certain criteria including, but not limited to, the following (Sec. 9):
• Affordability;
• Enrollee satisfaction; and
• Coverage of spiritual care services.

• Requires the operations of the Washington Health Benefit Exchange to be suspended if the exchange ceases to be self-sustaining (Sec. 26).

Full Bill Text