Navigating Health Coverage: A Comprehensive Look at the Washington Health Benefits Exchange on The Big O Show
On a recent episode of "The Big O Show," The Big O interviewed Manny Santiago, the Chief of Equity and Community Partnerships for Washington Health Benefit Exchange, to provide essential updates and information about health insurance options in the state. The discussion emphasized the importance of applying for coverage, despite the perception that navigating health insurance can be a daunting maze.
Open Enrollment and Access
Santiago noted that the Washington Health Benefits Exchange manages the platform wahealthplanfinder.org. This website is the marketplace where all Washingtonians can access health insurance plans that are approved by the Affordable Care Act (ACA), also known as Obamacare.
The open enrollment period runs through January 15th, during which people can shop and buy insurance that fits their needs. However, for enrolled tribal members in Washington, the application period is not confined to open enrollment; they can apply throughout the year.
Eligibility and Overcoming Barriers
One of the key messages of the interview was that all Washingtonians are eligible for the qualifying health plans. Eligibility is regardless of immigration status, income, and family composition.
Salisbury stressed that the perceived "hurdle" of accessing the Washington Health Benefits Exchange is often higher in people's heads than in real life. Santiago reinforced this, confirming that "every Washingtonian, regardless of immigration status, can come in and shop for the plans".
Santiago acknowledged that people often have mental barriers and objections about whether they will qualify, but encouraged everyone to apply, as they might be surprised for what you qualify for.
Assistance and Support
To help navigate the system, the Exchange offers a network of support:
Assisters and Navigators: These are trained individuals across the state who can help people navigate the potentially complex application on wahealthplanfinder.org. In King County, lead organizations include Seattle King County Health and Semar.
Producers (Health Insurance Brokers): These professionals are also available statewide to assist in selecting the best plan for a family.
Customer Call Center: The call center, with over 250 different languages available for assistance, can be reached at the toll-free number: 855-923-4633.
Application Language: The application itself is available in both English and Spanish.
Salisbury encouraged viewers to offer hands-on support to friends or family who are reluctant to apply by sitting down with them and going through the process together.
Understanding Premiums and Subsidies
Santiago clarified the mechanism of paying for coverage and the impact of federal changes:
Premiums: The Washington Health Benefits Exchange is the marketplace, but does not set the premiums; these are set by the insurance carriers.
Tax Credits/Subsidies: Eligibility for tax credits and subsidies depends on factors like family composition, income, and location. These credits are typically applied every month to offset the premium cost, rather than requiring the customer to pay the full amount upfront and receive a refund later. The system determines the amount of tax credits after the application is filled out and the data is analyzed.
The Impact of Federal Changes
Significant changes at the federal level are impacting health coverage, particularly concerning tax credits and subsidies. For instance, as of October 1 2025, the federal government decided not to offer tax credits to DACA recipients. Federal tax credits are only available to citizens.
Washington's Mitigation Strategies
In response to federal changes and resulting premium hikes, the state of Washington has implemented mitigation strategies:
Apple Health (Medicaid) and Cascade Savings: While federal tax credits are only available to citizens, the state provides state-only subsidies like Cascade Savings, which helps to offset the monthly premium. This state subsidy is available to populations such as DACA recipients and potentially undocumented individuals, depending on income and family composition.
Mitigation of Impact: Despite the environment being "really dire" and initial expectations that 80,000 people in Washington might lose insurance in 2026, the state's mitigation efforts are expected to reduce that number to around 40,000.
A Call to Action for Washingtonians
Santiago and Salisbury strongly encouraged everyone, even those who have received letters from their carriers announcing high premium increases, to still go to the website and fill out an application.
"The only way that people are going to find out whether or not they qualify for something to help with that is to…fill out the application on the website, and see what they qualify for,” Santiago said.
The overarching takeaway from the interview is clear: you won't know what you qualify for—whether it's a private plan, a state subsidy, or federal tax credits—until you fill out the application on wahealthplanfinder.org.
