As Congress looks at changes to the Affordable Care Act, the creators of Washington’s health insurance exchange are advocating for the state’s current system – with maps. Those maps show where the exchange has had the greatest rate of participation in the state: Trump country. Supporters of the Affordable Care Act say some members of the public don’t realize the impact the legislation has already had. Now the Washington Health Benefit Exchange is trying to tell that story at a website called 1in4WA.com. Washington exchange communications director Michael Marchand said in the past five years the exchange has grown to serve 1.8 million people, a quarter of the state’s population. “In doing that, we’ve managed to lower our state’s uninsured rate by over 60 percent and now less than 6 percent of our state’s population is uninsured,” he said.

That puts Washington in the top 10 nationwide in terms of insurance coverage. The counties with the highest use rate of the state exchange are rural: Adams, Okanogan and Yakima. They’re east of the Cascades and they voted for Donald Trump. Adams County had the highest use rate, 50 percent. In the election, 66 percent of voters chose Trump. About 40 percent of the people using the exchange make too much money to qualify for assistance – they’re using the exchange to compare insurance providers and comply with the mandate. But more than 60 percent of the people who have enrolled so far qualify for free or subsidized health care. The state had estimated 250,000 people would qualify for Medicaid; they got 600,000. “The numbers were coming in and we were just stunned. That’s a great thing, I mean getting all these people coverage is huge,” Marchand said, “because when you start looking at how much benefit it provides for us, getting these people to start thinking about their healthcare and getting preventive care, it’s great.”