Washington state budget proposals far apart on Exchange funding

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With Washington state budget proposals from both the House and Senate released, the long, arduous process of finding middle ground can now begin. Clearly, much of the debate will focus on revenue sources and education funding, but one of the most significant differences between the two proposals lies within funding for the Washington Health Benefit Exchange.

Prior to the session, the Exchange released a $147 million budget request that was met with skepticism from many legislators. The Governor’s budget proposal included $127 million, fulfilling most of the Exchange’s requests with the exception of diverting $20 million to the Department of Social and Health Services to increase their Medicaid enrollment capacity.

Last Friday’s release of the House budget proposal provided a similar level of funding, including a $124 million allocation for their operations, staffing, and call-center. This includes over $18 million from the state’s general fund, in addition to revenue from the premium tax, carrier assessment and Medicaid. The House proposal cites a larger than expected Medicaid enrollment as justification for the general fund support.

In the Senate, Tuesday’s budget release revealed an $85.9 million allocation for the Exchange, with $74 million dedicated to its operations. This allocation does not include any general fund appropriation, and assumes the passage of legislation that would move premium tax revenues on plans purchased on the exchange to the general fund, representing a $29 million reduction in funding. The budget allocation, and the related legislation, aim to make the Exchange fully self sustaining as required by the Affordable Care Act, though it is unclear how the Exchange would be able to maintain operations at its current level under the Senate’s proposal.

Where the middle ground lies at this point is still unclear, though it is apparent that there is considerable differences between the two chambers both fiscally and philosophically.