As enacted by the Legislature, the 2015-17 operating budget increases total budgeted funds for the Washington Health Benefit Exchange (HBE) to $110.0 million for the biennium. This is an increase of $77.0 million over 2013-15, and an increase of $30.0 million over the maintenance level (the cost of continuing current services).

The Seattle Times reports,

The exchange had asked the state for $127 million, plus $20 million in federal grants it already has received.

“This funding level will provide sufficient resources to run our marketplace,” Richard Onizuka, chief executive of the exchange said in a statement.

We usually discuss the state budget in terms of the NGFS+ (a synthetic account that rolls up the state general fund, the education legacy trust account, and the opportunity pathways account). But there are a number of state programs that are funded by the federal government or through dedicated accounts — the HBE is one of them, and most of its funding occurs outside the NGFS+. Indeed, the NGFS+ budget provides just $11.0 million for the HBE. These NGFS+ funds are to help cover costs related to Medicaid (Medicaid clients are now processed through the HBE website), for in-person assisters to help people enroll, and to support HBE operations.

A little over half of the HBE’s funding for 2015-17 comes from the health benefit exchange account. This account includes revenues from assessments on insurers that offer plans on the HBE and premium taxes. Under the Affordable Care Act, state exchanges must be self-sustaining as of Jan. 1, 2015. Self-sustaining sources of revenue “include, but are not limited to, federal grants, federal premium tax subsidies and credits, charges to health carriers, premiums paid by enrollees, and premium taxes.”

Also of note: Originally, the HBE had collected premiums from enrollees and passed them on to the insurers (premium aggregation). In December, the HBE board decided to leave premium collection to the insurers — hence the $2.5 million reduction in the budget.