By Marcia Stedman, HCFA-WA Board member
This month’s Universal Health Care Commission (UHCC) meeting opened with approving prior meeting minutes and hearing public comments, before launching into a discussion of governance and hearing a report on the baseline modelling of 3 existing insurance programs that cover the 3.4 million Washingtonians not covered by Medicare or ERISA plans.
The meeting closed with a decision to revisit the timing and structure of governance discussions, with a commitment to bring governance models from other states for review at the June meeting, and outlined the next steps to refine cost modeling, address benefit design, and develop legislative strategies.
Takeaway #1: Public comments are effective. Thanks to the many public comments throughout the Commission’s 4-year existence, the topic of governance led this meeting’s Agenda. Thank you, fellow health reform advocates, for speaking up! This meeting’s compelling comments begin at the 12-minute mark of the Meeting Recording.
Takeaway #2: The “Round 1” baseline modelling must be followed by more robust analyses that include administrative costs, as numerous other analyses have shown these costs account for 15-30% of health care spending (source).
- Scenario 1: All receive Medicaid-like benefits with zero cost-sharing and added dental, resulting in a $3.9–$7.4 billion annual cost increase depending on provider reimbursement rates.
- Scenario 2: All except Medicaid-eligible receive Public Employee Benefits Board (PEBB) UMP Classic design, with moderate cost-sharing and a smaller cost increase (estimated ~$1.5 billion).
- Scenario 3: All except Medicaid-eligible receive Cascade Care Silver design, with higher cost-sharing, resulting in a roughly cost-neutral outcome but reduced benefits for many.
Takeaway #3: Removing cost barriers increases system costs but improves patient health; maintaining barriers lowers system costs but risks harming patient health.
Bottom line: The key to designing a health system that improves patient health and well-being while also ensuring that system costs are sustainable lies in reducing administrative costs system-wide, to the greatest extent possible. And so, we come full circle to the overarching importance of getting governance right and the urgent need for the Commission to begin working in earnest on its charge to design a universal health care system for Washington with unified financing.
Save the date and join us at the next UHCC meeting on Wednesday, June 11th, from 2–5 p.m., when HCFA-WA is scheduled to present the Governance model outlined in our Washington Health Security Trust proposal.
And, join us on Thursday, May 15, from 2-4:30 pm, as we track the next meeting of the FTAC