Initial Medicaid Implementation: Washington first implemented their Medicaid program in July of 1966. Before the program began, it was estimated that 8% of the population would be eligible. The state had a Kerr-Mills program that financed the care for elderly individuals. The Kerr-Mills program transitioned from providing care from the OAA program to the MAA program in 1963. Through that transition, Washington’s payments and beneficiaries increased tenfold. A large part of that increase was that the Old Age Assistance program did not cover nursing home patients and the MAA program did cover these patients so the state transferred much of the state costs to the federal government. The state was one of several that did not consistently match the needs of the patients with the income of the patients therefore allowing more people to be eligible for services than the program was originally designed. This also drove up the costs of the program for Washington. The state did place significant limitations on what could be covered and limited hospital stays and drug coverage.
Key Medicaid Political Issues: Washington has been a leader in providing care to people who were ineligible for coverage. The state implemented the basic health plan program in 1987. The program was implemented to help people who made up to 200 percent of the poverty level afford public insurance that was subsidized by the state. The program was ended in 2014 as a result of the Medicaid expansion in Washington but the program was made into a national option for all states in the Affordable Care Act. Minnesota and New York have undertaken the program and have implemented it in their states in recent years.
Medicaid Expansion Implementation: Washington began Medicaid expansion in January 2014 with enrollment beginning in October of 2013. The state was one of five states that took up the option to expand Medicaid prior to the January 1, 2014 start date using state funds. The state had previously covered this population through their basic health program. The Medicaid expansion was passed through a line item on the state budget. The state moved the individuals that were eligible for the early expansion to the newly eligible expansion category following the Affordable Care Act’s Medicaid expansion implementation in 2014.
General facts about Washington Medicaid:
Medicaid program name: Washington Apple Health
CHIP Program name: Apple Health for Kids
Separate or combined CHIP: Separate CHIP
Medicaid Enrollment: 1.7 million (2017 estimate)
Total Medicaid Spending: $12.0 billion (FY 2017 estimates)
Share of total population covered by Medicaid: 22% (estimate)
Share of Children covered by Medicaid: 40% (estimate)
Share of Medicaid that is Children and Adults: 83%
Share of Spending on Elderly and people with disabilities: 40%
Share of Nursing Facility Residents covered by Medicaid: 60% (estimate)
Expansion state: Yes
Number of people in expansion: 601,000 (2017 estimate)
Work Requirement: No