With Medicare open enrollment right around the corner, Washington’s Office of the Insurance Commissioner has been working all summer to connect with communities across the state.
Last week, Insurance Commissioner Patty Kuderer made an appearance in Yakima, highlighting recent strides to reach Central Washington.
The Office of the Insurance Commissioner oversees the insurance market in Washington state. It also oversees the Statewide Health Insurance Benefits Advisors, or SHIBA — a program aimed at providing free, unbiased and confidential help to people navigating Medicare-related health care decisions. The program, which relies on local networks of volunteers, has been in place for more than four decades, but historically it’s only had one staff person serving Eastern and Central Washington.
When Kuderer took office earlier this year, SHIBA Program Manager Tim Smolen said they had a candid conversation about what the program needed.
“I said, ‘We need a person in Eastern Washington, and it needs to be a bilingual, bicultural person, not as a preference, but as a requirement, because that's what this community needs,” Smolen told audience members in a Sept. 25 presentation at the Yakima Salvation Army.
Changes in the region
Recently, that became a reality.
In August, SHIBA brought on Ari Laguna Antu as a regional training consultant for Kittitas, Yakima, Benton, Franklin, Columbia and Walla Walla counties. Laguna Antu was born and raised in Central Washington. Moving forward, she’ll be working with the region’s new SHIBA sponsor — Catholic Charities.
SHIBA offers technical training and continuing education for its volunteers, while regional sponsors help with recruitment, recognition and retention. Just a couple months ago, Catholic Charities took the torch from Yakima Valley College to step into those responsibilities. At this point, Yakima County has six volunteers, but Kittitas, Benton, Franklin, Columbia and Walla Walla counties have none. In the next year, Catholic Charities will be working to re-establish a volunteer network in those counties, said Stephanie Ketcham, the nonprofit’s associate director of volunteer programs.
Ketcham said the partnership aligns well with the nonprofit’s existing programs, especially its senior companion and volunteer services programs.
“It just seemed like it was a program that paired well with everything else that we were doing,” she said.
Smolen sees that, too. Across the state, SHIBA has 19 partners and around 210 volunteers. While that network is diverse, he said it stands to be even more so. Specifically, he emphasized the importance of recruiting more volunteers who share the lived experiences of people navigating the world of Medicare and Medicare Advantage.
“The program, long term, is not going to be relevant if it's perceived as being like a country club, right? It cannot just be the case that it's like a bunch of rich white people taking care of a bunch of other rich white people,” Smolen said. “I felt like, and I still feel like, they're very bought into that vision for diversifying their volunteer network.”
Challenges
This year, the Office of the Insurance Commissioner will be working through a changing landscape for insurance in Washington state.
In September, the office approved 12 health insurers to sell individual health plans in Washington’s Exchange in 2026. The office found that an average rate increase of 21% was actuarially justified due to increased utilization rates, rising health care and prescription drug costs, hospital consolidations, higher rates paid to care facilities and providers and uncertainty over federal action surrounding premium tax credits.
In essence, that means health insurance prices are rising.
More than 216,000 people with coverage from Washington’s Exchange qualified for help through federally financed Enhanced Premium Tax Credits in 2025, a news release from the state insurance office said. Those tax credits are expected to expire at the end of the year. If not renewed by Congress, Kuderer said around 80,000 people are expected to lose or opt out of their coverage.
“We don't like it. I don't like it. I know it's going to be painful for people, and I know the Legislature is going to have some tough decisions to make as to how we deal with this going forward,” Kuderer said of the rate increases. “But we are already thinking about, ‘Is there another way? Are there other creative things we can do to help people stay insured?’”
Medicare
Smolen said people on traditional Medicare are also seeing significant rate increases. Starting in January 2026, Washington and five other states will begin a prior authorization pilot program for traditional Medicare, initiated by the Centers for Medicare and Medicaid Services.
The goal is to increase efficiency and reduce unnecessary health care costs — but Kuderer said the company overseeing the program will be paid based on how much they save, giving a financial incentive to deny prior authorization.
“I have been around long enough to know that in medical situations, a delay in getting a prior authorization approved can be just as deadly as an outright denial,” she said, “and so I want people to understand that that is not the best structure for a prior authorization relief."
Getting help
Amid those impending changes, SHIBA and the Office of the Insurance Commissioner are working to help and answer questions.
At last week’s event, Smolen presented a new, free Medicare Open Enrollment toolkit. The kit can be used by SHIBA volunteers to guide people who want to enroll or switch plans during the open enrollment process, which starts Oct. 15.
Kuderer said she encourages people to reach out to her office if they have questions or need help.
“We want people to think of the Office of the Insurance Commissioner first whenever they have a question about insurance. We want them to know we are here to assist them, however and whenever we can,” she said.
