What is the Washington Cares Fund?

By Ron Lovell

WA Cares is a mandatory long-term care insurance program established by Washington state law in 2019. In our 2nd Wednesday Speakers Series (2WSS) June 12, 2024, Ruth Egger, consumer representative on the Long-Term Services & Support Trust Commission, and Erin Lee, Coordinator for No On I-2124 took us on a deep dive into the need for the WA Cares Fund and a 2024 ballot initiative that may destroy the program. Washington was the first state in the nation to create a public long-term care benefits program. 

This short video (53 min) of our 2WSS explains the program and the ballot initiative so that you can make an informed opinion when you vote.

Here are the key details about WA Cares Long Term Care Services program:

• Provides a lifetime maximum benefit of $36,500 (adjusted annually for inflation) that can be used to pay for long-term care services like professional care, equipment, home modifications, and compensation for family caregivers.
• Funded by a payroll deduction of 0.58% of wages from all employees in Washington state, with some exceptions.
• Benefits become available starting July 1, 2026, for eligible individuals  who have paid the premium for at least 3 of the last 6 years or a total of 10 years.

For complete information, go here.

Administrative Simplification Round 3: Health Insurance Plans vs. the Rest of Us

By Marcia Stedman

At its June meeting, the Universal Health Care Commission again tackled the topic of Administrative Simplification, this time hearing from a panel of 3 providers and 1 insurance executive.  The presentations reinforced what members of the public have been telling the Commission for years in their public comments.

All panelists agreed that simplifying administrative requirements was essential to lower the costs of care and improve patient access.  

Priorities for what to tackle first varied across specialties:  

• Physicians: prior authorizations, licensure delays, and clinic/pharmacy communication.
• Behavioral health: claims processing, timely payments from insurers, and ER follow-ups.  
• Insurance executive: too many interoperability standards across their “lines of business” and getting provider buy-in to the new standards.

Commissioners identified these priorities for simplifying administrative requirements:

• Better communication between pharmacies and medical clinics 
• Address the stigma of substance abuse, mental health and cost in lives lost, especially at the Federal level. Given Federal laws, what can we do at the state level?
• Lack of uniformity in pharmaceutical formularies, possibly caused by insurers chasing rebates.
• How does administrative simplification affect different provider types? 
• What are the unintended consequences for Medicaid patients? 
• Analyze savings from simplicity, as improvements may not give significant savings
• Help connecting the dots:  where would a universal health care system help on all of these good ideas?

There needs to be a set process or systemization for how legislative changes are implemented.  

For example, in 2019 an exception process for pharma to avoid prior authorizations was passed into law, but it is not well known. 

Staff will review these priorities and advise for the 2024 Report. 

This was a rich meeting with many details and is well worth viewing. The Panel presentations begin at 1:26:06 with Jeb Shepard.

The next UHCC meeting is August 8 @ 2-5 pm. Find the meeting materials and Zoom link here.

Meanwhile, please join us as we track the  FTAC meeting on July 11 @ 2-4:30 pm

We encourage you to:

• Sign up to provide public comment by 5 p.m. the day before the meeting occurs.
• We urge our members to push for a single payer plan in their public comments.
• Read our take on past UHCC and FTAC meetings

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