1. State of Reform LEGISLATIVE LEADERSHIP PANEL SENATOR DAVID FROCKT

2. AT A GLANCE: PROGRESS SINCE THE ACA WAS SIGNED  Fewer Washingtonians are uninsured or underinsured.  The uninsured population has dropped from an estimated 16.8% to approximately 8.65% as of the end of 2014.  More than 500,000 new adults now have coverage and care through Apple Health.  More than 170,000 adults and children are enrolled in a Qualified Health Plan, with three-quarters of enrollees qualifying for a tax credit.  Prior to the Exchange about 80% of those who purchased their own coverage had very low quality plans, with consumers often bearing 50% -75% of costs.  Plans now must include essential health benefits, including many important preventive screenings.  Uncompensated care costs have decreased.  Hospitals are spending less on charity care and avoidable ER use is declining.  Pre-existing conditions are no longer a barrier to coverage and care.

3. MORE PLANS, MORE CHOICE: INSURER PARTICIPATION  Comparison of the number of Qualified Health Plans (QHPs) available to small businesses :  For 2014, QHPs were available only in Clark & Cowlitz counties.  For 2015, plans were available in all counties, with 3 insurers offering a total of 23 QHPs.  Comparison of the number of QHPs available to individuals & families :  For 2013, 7 insurers offered a total of 35 QHPs.  For 2014, 10 insurers offered a total of 90 QHPs.  At the next open enrollment period, beginning Nov. 1st:  136 QHPs from 12 insurers will be available to individuals & families for 2016.  8 pediatric Qualified Dental Plans will be available from 6 insurers.  Businesses can select from among 47 QHPs offered by 3 insurers, two of whom will offer plans in all 39 counties.  Business coverage options will be available to larger companies of up to 100 employees.

4. Moving Forward: 2016 and Beyond  There is still work to be done – coverage does not always ensure access.  Gaps in access include:  Mental health care for children: Particularly psychiatric care.  Women’s health care: Access to the full range of reproductive health care is still limited, particularly in rural areas.  Pharmaceutical costs: Particularly access to medications used to treat cancer, HIV/AIDS, arthritis, MS, and other debilitating and life- threatening diseases.

5. 2016 and Beyond (cont’d)  Mediocre vaccination rates are creating risks for the most vulnerable.  We need to:  Educate parents about the multiple reasons for getting children vaccinated on time.  Communicate the importance of the HPV vaccine as a cancer prevention tool for both boys and girls.  Re-examine whether our state policy on opting out of vaccinations needs to be updated.

6. 2016 and Beyond (cont’d)  OTHER ISSUES TO MONITOR & ADDRESS  Lack of comprehensive regulation for electronic cigarettes & vaping products.  Increasing rates of opioid addiction & overdose.  Continuity of coverage and care.  Premium affordability for those who are ineligible for tax credits/subsidies.  The state’s Medicaid waiver application, designed to accelerate the state’s Healthier Washington efforts.