Washington Obamacare (Affordable Care Act) Facts 2020

Essential facts about the Affordable Care Act (ACA or Obamacare) in Washington, including whether you must get health insurance, how much it will cost, and how you can save money.


What Washington State Residents Need to Know About Obamacare for 2020


UPDATE: Due to the coronavirus (COVID-19) outbreak, Washington Healthplanfinder is OPEN for new health insurance signups.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

To begin, keep in mind these key points about health insurance in Washington:

1. Open enrollment has ended for 2020 health care plans, but you can still get health insurance if you qualify for a special enrollment period.

[UPDATE: Due to the coronavirus (COVID-19) outbreak, Washington Healthplanfinder is OPEN for new health insurance signups.]

In Washington, the ACA open enrollment period ended on December 30, 2019. This means that, unless you qualify for an exception, you won't be able obtain health insurance through Washington Healthplanfinder until the 2021 open enrollment period begins in the fall of 2020.

To learn whether you qualify for an exception that will let you get covered, see What Happens If I Missed the Washington Obamacare Enrollment Deadline?

2. You won’t face a tax penalty for going without health insurance in 2020—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you didn’t have health insurance coverage in 2019, you won’t have to pay a penalty when you file your taxes in this year.

Even though there's no more tax penalty, think hard about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty would. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.) Even if you've missed open enrollment for 2020, special circumstances may allow you to obtain coverage.

3. Your health insurance marketplace is located at Washington Healthplanfinder.

During open enrollment, or whenever you qualify for an exception, you can use the website Washington Healthplanfinder to choose your health insurance plan, apply for cost-saving tax credits, and get other help you need.

To learn more about enrollment, see How Do I Sign Up for Obamacare in Washington?

4. Health insurance premiums are finally dropping -- but out-of-pocket costs are still going up.

After five years of heavy premium increases, 2020 will bring some relief to Washington consumers: Prices offered through Washington Healthplanfinder will fall by an average of 3.27%. At the same time, however, out-of-pocket costs are going up. For example, the cap on out-of-pocket costs may rise to as much as $8,200 per person, and deductibles are going up, too.

Whether you're choosing a new plan or renewing the one you've got, look closely at the details to be sure you know how your plan works, and be sure you take advantage of any subsidies or programs that can lower your bills. And stay hopeful. For 2021, help may be on the way in the form of a new public option and additional subsidies (see below).

5. Premium subsidies are available to save you money.

Several forms of financial assistance can help you lower your health insurance premiums.

Fedral tax credits. The federal government provides help with premium payments for those whose incomes fall between 100% and 400% of the federal poverty level. For 2020, for example, a family of four earning as much as $103,000 can qualify for subsidies, as can an individual who earns up to $49,960. Though the subsidies are tax credits, they are automatically deducted from the cost of your premiums each month, as long as you purchase your plan through Washington Healthplanfinder.

Cost sharing reductions. More than half of the people who purchase coverage through a health insurance exchange receive "cost-sharing reductions" (CSRs). Originally, these were payments the federal government made to insurance companies that allowed them to reduce deductibles and co-payments for lower-income Americans. In 2017, the Trump administration stopped paying for CSRs, but insurers and many state regulators found a creative way keep the program alive—adding the costs to silver marketplace plans through a practice called “silver loading”—so CSR benefits remain available for 2020 insurance plans.

Keep in mind that cost-sharing subsidies are available only on silver plans. They will automatically reduce your premium if your income as no more than 250% of the federal poverty level. (For 2020, that means a family of four can't earn more than $64,375 and an individual not more than $24,980.) If you think you may qualify, look carefully at costs for the silver plans available at Washington Healthplanfinder while you are shopping for coverage.

Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Medicaid in Washington.

For more information, see Ways to Save Money on Obamacare in Washington.

6. Washington will soon have a public option for health insurance and (maybe) more subsidies.

Beginning in 2021, Washington will be the first state in the country to offer a public option for health insurance, called Cascade Care. The program looks different from what most of us think of as a "public option," because the state doesn't actually provide the insurance. Instead, the state will control the terms and manage the costs, while contracting with private insurance companies to administer the plans themselves.

The new program isn't expected to lead to dramatic savings for consumers but, if it works as expected, it will stem the tide of rising costs. The state is also considering the addition of state premium subsidies for those with income levels up to 500% of the federal poverty level

7.  Insurers aren't selling short-term insurance plans in Washington.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. Short term plans don’t have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. In the past, short-term plans were allowed to last only three months but under new rules you can purchase a non-ACA compliant “short term” plan that lasts as long as three years. In Washington, however, short-term health plans are still limited to three months and they are not renewable. Currently, no insurer is offering short-term plans in the state.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Washington.

8. You can get help signing up if you need it.

A couple years back, the Trump administration drastically cut funding for the programs that provide enrollment assistance. It also killed the budget for promoting the federal health insurance exchange. The good news is that Washington state doesn't rely on federal funding for its outreach and enrollment assistance programs so you still have plenty of options for free help.

An insurance agent or broker may be the best bet for sorting out your options. To find one or to learn about other support resources available to you, see How To Sign Up for Obamacare in Washington.

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