History and Purpose

WSHIP is the high risk health insurance pool for the state of Washington. WSHIP was established under the Washington State Health Insurance Access Act of 1987 (RCW 48.41) which was substantially amended in 2000 after the state’s individual health insurance market had collapsed in 1999 as a result of a combination of laws requiring guaranteed issue and community rating for applicants in the individual market. As stated in the Act, its purpose and intent is: 1) To provide access to health insurance coverage to all residents of Washington who are denied health insurance; and 2) To provide a mechanism to ensure the availability of comprehensive health insurance to persons unable to obtain such insurance coverage on either an individual or group basis directly under any health plan. The mechanism established by the 2000 amendments was the use of a Standard Health Questionnaire for applicants in the individual health insurance market to identify (and allow rejection of) high risk applicants for coverage, and offer the alternative health insurance coverage by WSHIP.

The Act has been amended several times since 2000. In 2013, it was amended to address health care reforms that were implemented January 1, 2014 as part of the Affordable Care Act. These included changes to restrict eligibility for WSHIP non-Medicare plans, discontinuation of the Standard Health Questionnaire, and a scheduled sunset date of December 31, 2017 for WSHIP’s non-Medicare coverage. In 2017, the statute was amended again to extend the sunset of WSHIP’s non-Medicare plans to December 31, 2022 and express the intent of the Legislature to further study the role of WSHIP in the future, as well as its funding mechanism.

Current Status

Non-Medicare Coverage
WSHIP’s non-Medicare plans are currently closed to new enrollment but WSHIP continues to provide coverage to individuals who were enrolled in those plans prior to December 31, 2013 and have elected to keep their WSHIP coverage.  By law, WSHIP’s non-Medicare plans will be discontinued on December 31, 2022.

Medicare-Eligible Coverage
WSHIP’s Medicare-eligible plan (Basic) continues to be open to new enrollment.  This plan provides supplemental coverage to individuals enrolled in Medicare and unable to obtain comprehensive supplemental coverage.