Concerns about Washington exchange budget

The Puget Sound Business Journal reports that Washington Health Benefit Exchange board members are concerned about its budget for 2015.

“I’m thrown. I’ve never seen a budget done quite like this,” said Ron Sims, former King County executive. He was attending his first meeting since being named the new exchange chair, although he hasn’t taken the helm yet.

Additionally,

Exchange staff members haven’t provided any updated numbers for that budget projection since November, although officials say they will start sharing details with the board’s operations committee next month.

Last fall, the exchange staff issued a rough proposal based on the state Legislature capping the exchange’s budget at $40 million — significantly less than the $65 million allotted for 2014 and much less than the roughly $85 million in 2013 that got the exchange up-and-running.

At that time, Bob Nakahara, chief financial officer of the state exchange, said that operating within that budget constraint would make it difficult to sustain high enrollment levels.

But enrollment so far hasn’t been that high: Through the end of open enrollment March 31 (plus some additional time for certain applicants), 164,062 private plans were purchased through the exchange (as of the April 23 report). The exchange had set an enrollment goal of 130,000 by January 2014 and 280,000 by the end of 2014. Enrollments didn’t exceed 130,000 until the last week of March.

Low enrollment makes it harder for the exchange to be self-sustaining (which it is required to be by Jan. 1, 2015), as the proceeds of a 2 percent tax on exchange sales are meant to fund the exchange going forward.

There are other funding issues as well, per PSBJ:

The exchange is also dealing with new challenges now that the federal government extended the open enrollment period for 2015 through Feb. 15 of that year. The exchange will have federal funding to support the cost of open enrollment only through the end of December 2014.