Building an Economy that Works for Everyone

Coming this Fall: Brand New Program Will Help Low-Income Child Care Workers Afford Health Insurance

As many as 33,000 child care workers in Washington will soon be eligible to enroll in a premium-free health insurance program through the Health Benefit Exchange. Recognizing the urgent need to help child care workers access affordable health insurance during the pandemic, the Washington State Legislature created a new program in the 2021 legislative session to provide health insurance premium subsidies to low-income child care workers. The program will begin this fall and will be available through the end of 2022.

Access to affordable child care is central to healthy children and families, gender equality in the workplace, and a well-functioning economy. But, due to a historic lack of public investment, child care continues to be prohibitively expensive, child care centers struggle to keep their doors open, and child care workers – disproportionately women of color – are often paid poverty wages. During the COVID pandemic, child care work was considered “essential”, but disparities in compensation and access became even more apparent, and as many as 1,000 child care programs had to close their doors.

In recognition of the importance of child care for working families, the Washington State Legislature included $30 million in our new state budget to create a health insurance premium subsidy program aimed at making health insurance more affordable for workers in the child care industry.

Here is what you need to know about the new program, who qualifies, and how workers can enroll.

What is the program and when does it start?

The state-funded program will cover monthly premiums for Cascade Care Silver level plans for employees of licensed child care facilities whose taxable income is less than 300% of the federal poverty level (FPL), which is the equivalent of a single person with up to $38,640 in income, or a family of four with $79,500. Premiums are the monthly fee consumers pay to insurance companies for enrolling in a health insurance plan. Enrollees will pay zero in monthly premiums but will still be responsible for other cost-sharing such as copays, deductibles, and coinsurance. The Washington Health Benefit Exchange will pay premiums on behalf of enrollees directly to insurance carriers.

The program may start as early as September but is required to be implemented by November 1st, 2021. The program is funded through the end of 2022.

Who is eligible?

Employees are eligible to enroll in the program if they meet the following criteria:

  • Work at a licensed child care facility including family home, center-based, and outdoor nature-based child care programs. Both child care workers and administrative workers are eligible.
  • Have incomes 300% of the federal poverty level or less. This translates to $38,640 for a single adult, or $79,500 for a family of four. Because of the complexity of taxable income, employees may be eligible even if they earn slightly above the cut-off.
  • Purchase a Silver level standard (Cascade Care) plan on Washington Healthplanfinder (
  • Apply for and accept all available federal premium subsidies.
  • Are not eligible for Medicaid or receiving Medicare benefits.

Hours worked and assistance from other state-based and federal programs should not affect eligibility.

Household members of a child care employee are not eligible for the program. However, it is highly encouraged that all members of the household be listed in the application, since they may be eligible for other programs, plans, and assistance.

What happens if a worker becomes unemployed or has a change in income?

Eligibility is assessed at the time of enrollment and again at the beginning of 2022. For example, if a worker has a change in income or loses their job during 2021, they are still eligible for coverage for the remainder of the year. However, if a worker becomes eligible for Medicaid, they will be automatically enrolled in Medicaid. To receive program coverage again in 2022, the worker would need to again meet the eligibility requirements. Changes to income, household composition, or home address should be reported to the Washington Healthplanfinder. Trained assisters can work with child care workers to determine eligibility and help make adjustments if needed.

How can workers enroll? 

Three main agencies are working together to implement and manage the new program: the Department of Children, Youth, and Families (DCYF); Yakima Neighborhood Health Services, and the Health Benefit Exchange.

  • DCYF will contact all employees of licensed child care facilities and provide them with initial program information, including instructions on how to enroll.
  • Specially trained assisters from Yakima Neighborhood Health Services will also contact child care employees, communicate program requirements, and help with enrollment. They will also be available to provide free language assistance.
  • During the enrollment process, child care workers select a Cascade Care (standard) Silver plan of their choosing and submit an application through the Washington Healthplanfinder site ( run by the Health Benefit Exchange.

What are the next steps?

Visit the Washington Health Benefit Exchange website, to stay informed, hear the latest updates, and download additional resources as they become available.

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