Washington State: Plans certified for 2024; Cascade Care preserves affordability for enrollees

A few weeks ago, the Washington HealthPlanFinder announced that 2024 ACA individual market rates for unsubsidized enrollees would be increasing by an average of roughly 8.9% overall (small group plan rate changes hadn't been finalized yet, though the requested increases averaged around 8.3%).

This week the WA ACA exchange confirmed that the individual market plans have been certified for sale starting on November 1st, while stressing the importance of strongly considering "Cascade Care" plans. Cascade Care is Washington States name for their quasi-"public option" plans:

Plans certified to be sold on Washington Healthplanfinder beginning Nov. 1

• Washington Health Benefit Exchange Board certifies 2024 plans

Washington Health Benefit Exchange (Exchange) Board certified 82 health insurance plans from a dozen carriers for plan year 2024. Additionally, the Board-certified 12 dental plans to be sold on Washington Healthplanfinder. Plans certified by the Exchange Board meet established criteria to be available on Washington Healthplanfinder during open enrollment, beginning Nov. 1.

“The good news is carrier participation in the individual market is stable; Cascade Care Select Plans (public option) are more affordable than ever; and standard plans make it easier for customers to shop and compare,” said Exchange CEO Ingrid Ulrey. “The bad news is, plans will be more costly overall in 2024, as premiums continue to rise, and federal and state subsidies remain flat. Again this open enrollment, the Exchange will support customers through Washington Healthplanfinder, our customer support center and our statewide network of navigators and brokers.”

Overall, the average monthly premium increase is 9 percent — or about $360 more per year — across the individual market. Increases of this magnitude cause significant challenges for customers seeking health insurance. We seek to help customers overcome these challenges by providing Cascade Care plans. Cascade Select plans remain some of the most affordable options on Washington Healthplanfinder. Cascade Select (public option) plans are now available in 37 counties, up from 34 in 2023. These plans are the least expensive Silver plan in 31 counties.

Cascade Care plans are popular, representing more than 60% of Exchange’s enrollment, with the fastest growing enrollment year over year. Enrolling in a Cascade Care Silver or Gold plan may qualify customers for Cascade Care Savings. These savings are available for individuals and families earning up to 250% of the federal poverty level (FPL) — an annual income of $33,975 for a one-person household and $57,575 for a three-person household.

Washington Healthplanfinder customers have widely varied experiences when buying health insurance. For example, consider a 37-year-old Spokane Valley resident who was enrolled in Washington Apple Health (Medicaid) in 2023. Upon redetermination, they were no longer eligible for Apple Health. They can get a 2024 Cascade Select (public option) plan with a $0 monthly premium, thanks to federal and state subsidies.

In contrast, a mature couple in Bellevue, who have too high of an income for federal or state subsidies, will pay more than $2,200 per month for their non-Cascade Gold plan premium. With a deductible of $5,000, copays and premium costs, this couple could be expected to pay $28,000 toward medical expenses in a year to treat a chronic illness, such as diabetes.

This second example is a bit of a head-scratcher. While it's technically accurate, the couple in question (assuming they're both 64 years old, just one year shy of Medicare) would have to earn nearly $250,000 in order to to have "too high of an income for federal or state subsidies"...and that's this year.

In 2024, assuming the benchmark Silver plan in their area increases by the statewide average of 9%, they'll likely have to earn upwards of $265,000...and that still assumes the current Federal Poverty Level thresholds, which are likely to increase by another 2-3% or so.

In any event, here's the second press release, focusing specifically on Cascade Care plans:

Cascade Care preserves affordability for Washington Healthplanfinder customers

• Washington Health Benefit Exchange Board certifies 82 plans for 2024

In advance of open enrollment beginning November 1, the Washington Health Benefit Exchange (Exchange) Board certified 82 health insurance plans and 12 dental insurance plans to be sold on Washington Healthplanfinder for plan year 2024.

While access to affordable health insurance remains a top priority for the Exchange, Washington Healthplanfinder customers face an average premium increase of 9% for the second year in a row. This is triple the state’s health care cost growth benchmark of 3%. Seventy percent of Washington Healthplanfinder qualified health plan customers are facing rate increases over 5% — with some customers experiencing increases exceeding 15%. All Washington Healthplanfinder customers are encouraged to shop available plans starting November 1st. Cascade Care Savings are available to qualifying customers which can lower monthly premiums to less than $10 a month.

“In its first year, the state’s premium assistance program, Cascade Care Savings, helped nearly 60,000 Washingtonians afford their health insurance. However, even with current federal and state subsidies available, year-over-year rate increases are unsustainable,” Exchange CEO Ingrid Ulrey said. “The Exchange is committed to continue working toward providing affordable and accessible health care to all Washingtonians.”

Washington Healthplanfinder’s Cascade Care Savings lowers customers’ monthly costs via state-funded premium assistance. These savings are available for individuals and families earning up to 250% of the federal poverty level (FPL) — that is $33,975 per year for a one-person household and $57,575 for a three-person household. Cascade Care Savings are available to customers who select a Cascade Care Silver or Gold Plan available exclusively on Washington Healthplanfinder. Many of the Exchange’s qualified health plan customers could benefit from these savings if they shop and switch to a Cascade Care Silver or Gold plan during open enrollment starting November 1st.

Cascade Care plans, available in every Washington county, continue to grow in access and enrollment year-over-year — with more than two out of three qualified health plan customers enrolled in a Cascade Care plan in 2023. These plans remain some of the most affordable options on Washington Healthplanfinder and provide standard benefit design, allowing easier comparison between plans. Cascade Care plans let customers pay less at the doctor’s office, with more predictable costs.

Cascade Select (public option) plans are the least expensive Silver plan in 31 counties, before any available subsidies. While average plan premiums for 2024 are up, Cascade Select plans have average premium increases nearly 50% lower than non-Cascade plans. These plans are now available in 37 counties, up from 34 in 2023.

“We look forward to continued engagement with the Legislature, Governor's office, and state agency and carrier partners,” Ulrey said. “The Exchange is committed to providing all Washingtonians access to low-cost, high-value health insurance on Washington Healthplanfinder.”