1. Navigator-Certified Application Counselor TAC
Please use the conference line provided in the webinar panel, including the audio pin, if possible. This reduces feedback on the line and improves the sound quality.
Be with you in a moment!
Navigator-Certified Application Counselor TAC
May 17, 2017

2. Members Angela Ward Northeast Washington Health Programs Char Massong
Swedish Medical Center
Che Lee (Outreach)
CGI
Courtney Normand (Outreach)
Planned Parenthood Votes Northwest
Curt Fackler
Better Health Together
David Escame
Amerigroup Washington
John Bennett
Choice Regional Health Network
John Hamje
Office of the Insurance Commissioner
Jose Rodriguez
CHC of Snohomish County
Kristin Ely
Unity Care Northwest
Mary Wood (Outreach)
Health Care Authority
Odin Ifrim
Valley Medical Center
Randy Moyer
Legacy Health
Rhonda Hauff
Yakima Neighborhood Health Services
Venus Tarbell
Puyallup Tribal Health Authority
Whitney Johnson
Foundation for Health Generations

3. Agenda Exchange Updates Federal-state legislative activity
Navigator Program updates
HBE

4. Exchange Updates TAC Recruitment Open Enrollment 5
Special Enrollment Period
Consumer decision support tool
SEP verification
Carrier rate filings June 7
Carrier Summit
Effectuation files
Payments

5. State Legislative Update
Special Legislative Session (started April 24)
HBE Budget request
SHB 1291 – premium assistance program for low-income WA residents who are citizens of the Marshall Islands, Micronesia, and Palau

6. Federal Legislative Update
Congressional Actions
American Health Care Act (HR 1628)
Passed House May 4 ( )
House Democrats unanimously opposed and were joined by 20 Republicans
Moved to Senate

7. What’s in the AHCA? Medicaid
Shift from entitlement program to a per-capita spending cap
Qualified Health Plans
Tax credit eligibility shifted from income-based amount tied to premiums (SLSP) to a fixed amount based on age
Tax credits can be used off Exchange in 2018
CSRs eliminated
State stability fund offsets low-income consumers (130 billion over 9 years)
Individual mandate eliminated
Adds continuous coverage requirement with 30% premium surcharge for lapse in coverage

8. AHCA amendment AHCA, as amended, allows states to waive:
Age rating – states may use higher than 5:1 ratio starting in
Essential Health Benefits – states can specify their own EHB starting in 2020
Community Rating – states can add “health status” as a factor in setting premiums starting in 2019
High risk pool
May not be waived for those with continuous coverage
Federal funds to offset costs of people with pre-existing conditions
$8 billion over 5 years

9. AHCA – what’s next Bill moved to Senate
Substantial changes expected (Byrd rule, Medicaid)
50 votes needed to pass (52R; 48D)
Both Chambers must pass the same bill to send it to the President for signature
New Congressional Budget Office score

10. HHS Market Stabilization Rules
Intent of regulations is to stabilize the individual and small group markets
Increase proportion of younger, healthier enrollees
Reduce incidence of people enrolling only when sick
Stabilize/reduce rates
Keep carriers in the market
Requested by Carriers

11. HHS Rules Adopted
Implements shorter open enrollment to 45 days (Nov. 1 to Dec. 15) in 2017 rather than 2018
Adds flexibility in actuarial value of plans impacting metal tiers
Tightens Special Enrollment Periods for individuals with qualifying life events
Pre-verification by Exchange (optional for SBE, timeline flexible)
Gives Carriers more options when enrollees have unpaid premium payments due

12. Cost Sharing Reductions
Federal spending bill does not include CSR payments
Agreement from Administration to maintain monthly payments
Unspecified time frame
House v. Price action scheduled for May 22 (status report due)

13. Shortened enrollment period
Lead Org ideas –
Get new QHP information out earlier with a way to compare plans and estimate costs fairly accurately
Receive reports/leads prior to open enrollment (September)
Train navigators to complete enrollment first, report changes later
Earlier and increased notification – especially electronic
Send notices in a color that stands out
More advertising/marketing statewide that drives people to navigators
Collaborate with carriers on their notices – particular deadlines
Begin outreach earlier
Text messaging

14. 2017-2018 Strategic Plan Draft Outline
Mission:
The Washington Health Benefit Exchange seeks to redefine people’s experience with health care by radically improving how Washingtonians secure health insurance through innovative and practical solutions and an easy-to-use customer experience. These are reflected in our values of integrity, respect, equity, and transparency as it relates to those we work with and those we serve.

15. Next Meeting: July 19, 2017