By Elaine Cox, MPP, BSOT, HCFA-WA Board Member

“Don’t lose sight of our existing goals in these challenging times”- Senator Annette Cleveland, UHCC member and Chair of Senate Health and Long-Term Care Committee

The April 30, 2026 Universal Health Care Commission (UHCC) meeting featured robust comments and discussion about the potential promises and pitfalls of instituting Universal Primary Care (UPC) in Washington, and the best use of the $250K proviso funds to do economic modeling related to the UHC work plan. The UPC proposal has strong support from several Commission members. HCFA-WA and others expressed concerns that focusing on UPC could divert critical resources and attention away from designing a true single-payer system.

A recording of the meeting on TVW can be found here.

Highlights:

Universal Primary Care (UPC) as a possible transitional step toward universal health care (UHC) was explored. The proposal was presented to the Commission in February, 2026 by the Office of the Insurance Commissioner. (OIC). Discussion will be ongoing in future meetings, in both the UHCC and Financial Technical Advisory Committees. 

How to use the $250K proviso funding for economic analysis, including whether/how to use it to study UPC. Creating a workgroup to inform the decision was proposed. The Financial Technical Advisory Committee (FTAC) will continue developing their proposal.

Provider Reimbursement Guiding Principles were finalized and adopted, as developed by the FTAC.

 HCFA WA engagement, along with advocacy partners, is having an impact!

Engaging with the UHCC is a top priority for HCFA WA. The Commission is crucial to achieving single payer universal health care in Washington state. 

How we engage:

• Members attend and present comments at each meeting. 
• One of our policy team members, Roger Gantz, is on the FTAC.
• We occasionally meet with individual Commissioners to exchange information, identify potential legislative opportunities, and further explain the rationale for our positions.

Examples of our impact:

• Changes proposed by HCFA WA were included in the finalized Provider Reimbursement Principles. 
• Commissioners referenced our long list of questions regarding the universal primary care model several times in today’s discussion.

HCFA-WA Comments (Cris Currie at 7:37, Shari McEvoy at 12:44,)

HCFA WA policy team members Cris Currie and Shari McEvoy provided verbal and written comments: 

• Enrollment: UHCC should model the enrollment process in a single-payer system on California’s (AB 1900), and to have residency requirements align with Apple Health’s.
• Provider reimbursement: on principle #6, we recommended eliminating using financial rewards and punishments to incentivize healthcare providers, while still emphasizing quality of care. 
• Universal Primary Care: primary care is extremely important to UHC, but now is not the time to take on a new topic and divert attention from much more urgent design components.
• Use of the OIC proviso: The $250,000 would be best spent on financial analysis relating to UHC, rather than UPC. Some possibilities include:

 Public comments from other groups and individuals emphasized:

• The complexities and costs of navigating a fragmented system
• Support for a UPC proposal to hasten urgent access to needed coordinated care.
• Concerns about UPC as a diversion or impediment from progress on UHC, along with risks and uncertainties of this untested approach.
• OIC proviso should be used to measure overall costs and benefits of a UHC model.
• Urgency, especially in light of HR1, federal changes to Medicaid and Medicare. Rural Washingtonians are especially susceptible.

Twenty comments, written and verbal, were submitted, which is a new record for these meetings. 

Finance Technical Advisory Committee (FTAC) Update (50:04)

• FTAC has been focusing extensively on the UPC model proposal. (See our recap of the March 2026 FTAC Meeting here.)
• FTAC explored systemic constraints, including the primary care provider shortage and a lack of medical residency training slots, while expressing strong support for integrating behavioral health into primary care.

Agenda Discussion

Universal Primary Care Model was presented by Commissioner Jane Beyer and extensively discussed by FTAC members and Commissioners.  (54:09)

What is the UPC Model?
Features of the model:

1. Primary care (PC) is offered to all WA residents as a non-insurance benefit, that would be “carved out” of the usual insurance benefit.
2. Consumer health insurance for other care would “wrap around” and coordinate with PC.
3. Coordinated/collaborative care model. Care is delivered by an interdisciplinary team integrating behavioral health, advanced PC and care coordination.

Discussion centered on:

• Additional information and resources needed to make a decision about adopting a UPC model as a transitional step to UHC. 
• Potential use of OIC Proviso funds to support exploration of the model
• Commissioners noted that UPC could be a way for the state to meet its statutory requirement, (SB 5589),to progress toward spending 12% of total health care dollars on primary care.
• The workplan would require revised target completion dates. 

Graphic source, slide 42

Office of Insurance Commissioner (OIC) Proviso Considerations (1:41:13)

The OIC has a $250,000 state appropriation to work with the Health Care Authority to do financial modeling relating to the design of a universal health care system. The funds must be spent during the biennium ending 6/30/2027. 

The discussion centered on whether the funds should be used for analysis of a UPC model vs the overall UHC model, and what components would be explored. The creation of a 6-9 month long workgroup to advise on use of funds was discussed, but no vote was taken on this.

Provider reimbursement  (2:06:56)

FTAC presented its finalized reimbursement guiding principles document, and the Commission voted on and adopted the document (2:09:40). They also presented a draft proposal for input relating to detailed high-level provider reimbursement and participation elements. FTAC plans to vote on a revised proposal in May. (2:20:30)

Link to April 30 2026 TVW Video

Meeting Materials Here 

Next Meetings:

UHCC: Thursday, June 18 2–5 p.m., Details available here closer to the date.

Comment to the UHCC

• Speak during the designated public comment time at UHCC meetings. Sign up to provide public comment by 5 p.m. the day before the meeting occurs. 
• Email [email protected] at any time.  If you submit your comments less than two weeks before a meeting, they will be included in the following meeting’s materials.

We urge our members to push to use OIC proviso funds for economic analysis focused on the entire single-payer universal healthcare system, rather than universal primary care, in their public comments.  

• Read our take on past UHCC and FTAC meetings

• Subscribe to Health Care Authority (HCA) for updates

Now Available, the Universal Health Care Commission 2025 Annual Report

 FTAC: Thursday, July 16 2–4:30 p.m.- Details available here closer to the date.

Comment to the FTAC

• Speak during the designated public comment time at FTAC meetings. Sign up to provide public comment by 5 p.m. the day before the meeting occurs. 
• Submit written comments at any time.  If you submit your comments less than two weeks before a meeting, we’ll include them in the following meeting’s materials.

 ARE YOU INTERESTED IN SERVING ON THE UHCC? 

Currently, there  are two open seats on the Commission, subject to appointment by the Governor. Candidates should have knowledge and experience regarding health care coverage, access, and financing, or other relevant expertise.  Apply to Serve here

View the Meeting materials

Watch the Meeting Video