By Donna Gordon Blankinship
The Associated Press
SEATTLE — The chairman of the House Appropriations Committee has a message for the people who run the Washington health care exchange: Tell us exactly how you’re spending the taxpayers’ money, or you won’t get any more state dollars to spend.
“Right now, the Legislature isn’t happy,” said Rep. Ross Hunter, D-Medina.
Officials at the Health Benefit Exchange have been too vague on their budget request to satisfy Hunter and other lawmakers from both parties and both the Senate and the House.
But Hunter assumes it’s more of a learning curve about how much detail the Legislature needs than obfuscation. Until now, the state has relied mostly on federal dollars to set up its operation.
Enrollment ends soon
Part of the problem is the exchange budget is dependent on information that won’t be available until after health insurance open enrollment ends this Sunday.
Another issue: The exchange gets state, federal and corporate dollars, so its budget is a little more complicated than some other state agencies.
The exchange is asking the Legislature to OK $125 million for its operating budget for the next two years. It needs the money to keep improving its operation and marketing to new, harder-to-reach customers.
Those dollars are supposed to come from four sources:
■ A 2 percent premium tax that is part of the cost of buying insurance through the exchange. If the exchange meets its goal of selling 213,000 insurance policies this year, that tax is expected to bring in about $39 million.
■ About $21 million in fees charged to the insurance carriers for allowing them to make money through the exchange.
■ Almost $49 million from federal Medicaid grants to the state because people use the exchange to sign up for the free insurance known in Washington as Apple Health.
■ About $17 million in federal grants that were originally earmarked for setting up the exchange.
But open enrollment is not going as well as exchange officials were hoping it would.
As of last Thursday, the exchange had signed up 132,000 people for private insurance this season. They are expecting thousands more to sign up before open enrollment ends Sunday.
The most optimistic numbers being tossed around would have enrollment total 160,000.
No one knows for sure what the future will bring, but that number is 75 percent of the goal.
At that level, the exchange would come up $10 million short in premium taxes.
Sen. Randi Becker, a member of the Senate Ways and Means Committee, said the Senate is also concerned about the health exchange budget request. The Republican from Eatonville said she’s been concerned for a while about how the agency is going to become self-sufficient.
State budget dollars
Unlike Hunter, however, she is not as willing to give it more time to learn the state budget system after relying on mostly federal dollars during its startup years.
“I would say it’s more that they don’t want to tell us,” Becker said. “I don’t think they want to look bad. Every business has ups and downs, but you have to get it out on the table so it can get resolved.”
Becker would like to see a lot more clarity from the exchange on its budget, how it’s spending money and what the federal law requires it to do and what is extra.
She had expected the exchange to ask for more money but was surprised at the $125 million request.
Hunter, the House’s chief budget writer, said it is likely to walk away from the legislative session with less money than it requested.
“They’re asking for more money than I’m likely to give them, which is true for most groups that come into my office,” Hunter said.
Exchange officials say they will make do with less if they have to.
“We’re looking at our numbers, and we’re prepared to do what it takes to live within our means with what the Legislature provides us,” said exchange spokesman Michael Marchand.
They realize that if they don’t hit their enrollment goal, the state will receive less money from the premium tax and have less to pass along to their operation.
A member of the exchange volunteer board wasn’t ready yet to give up on its enrollment goals.
Extend deadline?
Teresa Mosqueda said she would be in favor of extending the deadline beyond Feb. 15 and making more of an effort to reach out to the people who have not yet renewed their insurance for this year.
“The questions that lawmakers are asking are the same questions that board members and community members are asking,” Mosqueda added.
“We want to know why there’s a lack of enrollment and what we can do to improve the retention rate. We also all want to know what happens if we don’t hit our enrollment goals.”
