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Health care reform

Better health, better care, lower costs: That is Washington's focus through health care reform and transformation.

The Affordable Care Act (ACA)

The Affordable Care Act (ACA) became law in 2010 to increase the quality and affordability of health insurance. It has brought major improvements to our health care system, giving millions of Americans access to high-quality, low- or no-cost health care coverage.

In Washington, health care reform has allowed more than half a million adults who were previously uninsured to enroll in Apple Health (Medicaid). We also created a health benefit exchange to offer affordable health and dental insurance coverage that meets ACA requirements. Tax credits or financial help is available to pay for co-pays and premiums.

We have experienced an unprecedented 10-point drop in the uninsured rate in Washington—one of the highest drops in the rate of uninsured in the country. In fact, Gov. Jay Inslee set a goal of reducing Washington’s uninsured rate to 6 percent by the end of 2017. We reached that target two years early.

The Affordable Care Act (ACA) ensures that:

  • Parents can keep kids on their insurance until they are age 26.
  • There is no lifetime cap (or limit) to how much insurance will pay.
  • There is no annual cap (or limit) to how much insurance will pay.
  • You cannot be denied coverage if you have a pre-existing condition.
  • You cannot be dropped from your insurance if you get sick.
  • Insurance must cover certain essential health benefits, such as hospitalization, doctor visits, prescription drugs, pediatric services, maternity and newborn care, lab services, and mental health and substance use disorder services.

The ACA requires that almost everyone have health insurance. In Washington, most individuals who needs to get health insurance can use Washington Healthplanfinder — our state’s health benefit exchange. To learn more about eligibility, benefits and services, or how to apply, visit the Apple Health (Medicaid) coverage section of our website.

Healthier Washington

The Affordable Care Act also supported innovation by creating an Innovation Center, which encourages Medicare and Medicaid programs to test models that improve care, lower costs, and better align payment systems to support patient-centered practices.

Through the Innovation Center, Washington received a State Innovation Models grant to catalyze our efforts to improve how we pay for services, ensure health care focuses on the whole person, and build healthier communities through a broad collaborative regional approach.

Learn more about our Healthier Washington work.