Next fall Washington’s health exchange is expected to be up and running. The exchange is an online market for health plans, mandated by the federal Affordable Care Act. Right now the state's Health Exchange Board is trying to figure out how to pay for itself.
It's also trying to figure out who should pay for it. Should funding come from people who use the online market? Or should that cost be carried by everyone in the state who buys a health plan?
Michael Marchand is spokesperson for the state’s Health Benefit Exchange. He says at the heart of the matter is what kind of benefit the exchange provides.
"Is it something that exists at a broad base -- that is, something that would benefit to all of us as a state? Or is it something that is really providing benefit only to those who use it?” That, he says, is a big question.
The Health Exchange Board hopes it will get some answers when the Legislature convenes in January. It’s sending three funding options.
Right now anyone who buys health insurance pays a fee. One option would be to increase that fee. Another option would be to tax people who purchase their plans through the online exchange. The third is a hybrid of the two.
There’s one complication. It’s not clear whether any of these options would require a two-thirds vote from the Legislature, rather than a simple majority. Washington voters reaffirmed a supermajority requirement for tax hikes in the Legislature in this year's general election.