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March 2023 e.Bulletin

Washington State Legislative Cutoff Calendar 2023

The legislative session (January 9 - April 24) is approaching the home stretch, and plenty of legislative action opportunities are still to be had. The cutoff for bills being voted on in their house of origin was March 9. Bills are now being considered in fiscal committees in the opposite chambers until April 4.  

Watch your email and HCFA-WA’s social media for upcoming opportunities to take action!

Senate and House Budgets Fund Immigrant Health and Universal Health Care Commission (UHCC)!

HCFA-WA’s top-tier legislative actions depend heavily on the budget. HCFA-WA has been advocating strongly for appropriations for immigrant health and the UHCC

Immigrant Health 

Both the Senate and House budgets proposed significant appropriations (appears to be about  $20 million from the Senate and $95 million from the House) for a statewide Medicaid-like health insurance program that would cover uninsured  adults regardless of immigration status. The amount and sources of funding, eligibility requirements and other program features will continue to be negotiated and amended through the legislative cycle. 

Estimates show that approximately 30,000 uninsured immigrant residents in Washington would be eligible for health insurance through this program, beginning in January 2024. Caseload forecasting anticipates an initial enrollment of 1500, increasing to 7000 after four years.

Finance Technical Advisory Committee (FTAC) of the UHCC

Both the Senate Ways and Means and House Appropriations committees endorsed the following funding, matching HCFA-WA’s proposals:

  • $132,000 for 2024 and $125,000 for 2025 for additional staff dedicated to the work of the FTAC 
  • $250,000 for 2024 and $250,000 for 2025 for consultant services, dedicated actuarial support, and economic modeling

This additional funding would expedite FTAC work, we hope through enabling more frequent small group meetings that would require additional administrative coordination and support.

Expert dedicated actuarial support and economic modeling can demonstrate how a publicly funded system will achieve substantial savings over the current system, while ensuring that all Washingtonians are covered.

What is the FTAC? This UHCC committee provides subject matter expertise and advises the UHCC on developing a financially feasible, publicly funded model. Roger Gantz, who serves on the HCFA-WA Policy committee, is a member of the FTAC. Through his work on the FTAC, he represents our vision of how publicly funded universal care can be achieved. Roger was Policy Director for Washington Apple Health (Medicaid) and has worked with lawmakers on health care reform for low-income individuals.

HCFA-WA has been meeting regularly with individual members of the UHCC and FTAC to create dialogue, and offer resources and experienced perspectives from our members who have worked for decades on UHC legislation and advocacy.

SJM 8006 This Joint Memorial bill is a formal request from the legislature to the federal government.  It requests to either create a universal health care program or, absent federal action, partner with the state to implement a single-payer health system. To allow the state to implement a single-payer health system, Congress could pass House Resolution 3775 or grant the state the appropriate waivers.  The bill has passed the Senate and now the House Health and Wellness Committee.

SB 5729 - No Expiration Date for Insulin Price Cap! 

The expiration date of January 2024 was removed for limiting out-of-pocket expenses to $35 for a 30-day supply of insulin. This bill sailed through both houses, with great bipartisan support.

For more information about this and other  legislation that we’re supporting this session, visit the Current Legislation page on our website.

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Spotlight On: FTAC
by: Marcia Stedman, Immediate Past President, HCFA-WA Board

Transitional Solutions, Medicare Questions, and Lessons from the Indian Health Care Delivery System

If the devil is in the details when it comes to funding universal health care, members of the FTAC (the Committee) showed they were ready to deal with the ogre in the room. At meeting #2, they tackled two important topics: sorting through transitional solutions to achieve the goal of universal health care and discussing options for including Medicare enrollees in Washington’s universal health care system. They also heard a solution-packed presentation on Washington’s Indian Health Care Delivery System

1. Transitional Solutions Toward Universal Health Care

Consolidated purchasing for state programs generated the widest-ranging discussion and general agreement that this solution be recommended to the full UHCC (the Commission) for further study. Because the state currently controls 30 percent of the insured market through the Medicaid, Exchange, and Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) benefit programs, this would be a high-impact (although somewhat resource-intensive) solution that would prepare Washington for a universal health care system. 

Auto-enrollment of those not eligible for Medicaid to the no-premium plans on the Health Benefits Exchange. Currently being done in other states, this high-impact and less resource-intensive solution also generated interest, particularly as the end of the public health emergency will result in many Washingtonians losing their Medicaid coverage within the next six months.  

Out-of-network price caps on providers is another high-impact and less resource-intensive solution that has led to lower in-network reimbursement rates in other states.

Regulated hospital global budgets would have the highest impact of the solutions discussed, but would be resource-intensive due to the current fractured payment system and the political challenge of obtaining the necessary legislation.   

2. Medicare: To Include or Not To Include?  

The Committee had plenty of questions:

  • How would Washington even do this, absent a consolidated system?
  • What cost/benefit analysis is needed? 
  • How would payment work? What would the benefits be? Would it be feasible?
  • Would this be a state plan, contracted through a managed-care organization? 
  • Would it be offered as an option to current Medicare patients?
  • Can we afford it?
  • Can we get per-capita trend data?
  • Can we pursue a waiver at this time?
  • Should we take Medicare off the table?

In the end, the Medicare question seemed a bit like a hot potato lobbed between the full Commission requesting options for including it in our state plan and the FTAC needing direction from the Commission around its vision for the system and benefit design.  Clearly, this topic needs further discussion, especially because it threatens to drain energy away from developing an achievable system that works for everyone who is not yet on Medicare. This topic is sure to be on the agenda for the next FTAC meeting on Thursday, May 11, 3-5 p.m. and at the upcoming UHCC meeting on Tuesday, April 11, 2-4 p.m.

3. Washington’s Indian Health Care Delivery System Is a Universal System

During this discussion, which was sandwiched between the transitional solutions and Medicare discussions, Vicki Lowe, Executive Director of the American Indian Health Commission (AHIC) and Chair of the Universal Health Care Commission, explained that by enrolling all tribal members in the state’s Medicaid program and providing wrap-around services as needed, they can deliver the same quality of affordable healthcare to all enrollees, regardless of age, income, or employment status. There are challenges, notably around funding, but this model can inform the Committee’s work and help our state achieve its goal of affordable, high-quality healthcare for every Washington resident.

Following are the meeting materials and a video recording of the meeting:

Mark your calendar for these upcoming meetings:

Get Engaged!

Got comments? All UHCC and FTAC meetings are open to the public, and public comments are encouraged. Sign up to provide public comment during a meeting by 5 p.m. the day before the meeting. If you want your written comments to be included in an upcoming meeting, email your comments two weeks before that meeting by contacting the Health Care Authority (HCA) at any time. Subscribe here to receive meeting notices in your own inbox


HCFA-WA March 8th 2nd Wednesday Speaker Series
: Legislative Update: Making sausage before our very eyes

There was substantial interest in our 2nd Wednesday Speaker Series presentation on March 8. During this informative session, HCFA-WA Policy team volunteers and our lobbyist, Lonnie Johns-Brown, provided a legislative update on how things stood 60 days into the 105-day session. Lonnie provided a great bird’s eye view of the current legislative landscape and the importance of the upcoming budget for our legislative priorities. Great background on the bills was provided by members of the HCFA-WA Policy team.

Watch the video here

Health Care Cost Transparency Board February Meeting Highlights

The HCA Health Care Cost Transparency Board (HCCTB) meets monthly. The Board is charged with setting benchmarks for the state’s health care cost growth and making costs more transparent to payers and the public. Here are some February 2023 meeting highlights.

Consumer Experience in the Public Option

This month’s meeting featured a presentation of the HCCTB plan to prepare a July 2023 report on the consumer experience of benefits, premiums, and cost sharing for enrollees in the Cascade Select plan. Cascade Select is Washington’s public option plan offered under Cascade Care. This plan tripled its enrollment, to 27,000 enrollees in the last year. 

Adjust for Inflation?
The Board spent considerable time discussing how and whether the benchmark cost growth figure should be adjusted to account for inflation. The challenges in getting timely data on different types of inflation were raised. Later adjustment to account for inflation data lag time might be necessary. The Board voted not to adjust for inflation. Instead, they would continue to study the matter when more data is available.

Cost Growth Driver Analyses: Prices Up in Pharmacy and Hospital Spending
The high-level analysis is that from 2017 to 2021, hospital and pharmacy prices drove overall health care spending growth. The Board considered a drill-down analysis to develop strategies to mitigate this, and identified areas for staff to gather further data.HC_News_Bar_(2).png

Washington State Health News

The COVID-19 Public Health Emergency period has ended, and Medicaid enrollees could lose coverage: Apple Health (Medicaid) eligibility was extended during the pandemic, which helped Washington to achieve record-low rates of people uninsured during the pandemic.

As many as 300,000 Washingtonians may lose coverage after their present term. Eligibility criteria are detailed on the HCA website. 

Updates on other states’ single payer healthcare initiatives

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Tues, Apr. 11

 

Universal Health Care Commission (UHCC) Meeting.
2-4:00 p.m.
Sign up to present live public comments by 5 p.m. Monday April 10


Wed, Apr. 12
 

Physicians for a National Health Program Zoom Webinar: 
Lessons from Abroad: What can other nations teach Oregon about better health care?
1:00 p.m.

Wed, Apr. 12

 

HCFA-WA 2nd Wednesday Speaker Series: The Oregon Trail to Universal Health Care
7-8:00 p.m.
via Zoom
RSVP here!

Sat, Apr. 15

 

Physicians for a National Health Program Monthly Meeting - Washington
7:00 p.m.
Check the website for the link.

Apr. 17-23

 

Medicare for All Strategy Conference

The annual Medicare for All Strategy Conference will take place ONLINE, and will include a week of evening events followed by a weekend of live workshops. $35 Early Bird tickets until March 31, $50 after March 31.

Wed, Apr. 19

 

Health Care Cost Transparency Board
2-4:00 p.m.
Meeting materials and Zoom link when available

Fri, Apr. 21

 

One Payer States: Third Friday Meeting 
9:00 a.m.
Check the 
website for the link.

April 27-30

 

 

Seattle/King County Clinic - volunteer-driven clinic

This clinic provides free dental, vision, and medical care at Seattle Center.

Thurs, May 11

 

Finance Technical Advisory Committee
3-5:00 p.m.
Meeting materials and Zoom link when available.

 

Please support our work.

The perfect gift for every universal health care supporter, any time of year: Everybody In, Nobody Out t-shirts, winter scarves, and umbrellas.


Join the Take Action Network

We are working to enhance our legislative advocacy positions and actions by using TAN, a web platform developed by Daniel Weise in cooperation with Washington Indivisible Network. TAN provides a web-based platform for anyone who wants to be more actively engaged in Washington State legislative actions.

We invite you to join TAN. You'll be provided with an initial profile that will allow you to follow:

  • Health Care for All-Washington legislative advocacy work
  • The work of other advocacy organizations that most relate to your primary issues
  • Events and civil actions of interest to you

Organizations that use TAN include the Faith Action Network (FAN), Environmental Priorities Coalition, RE Sources, Fair Vote Washington, 350.WA, and many more.

Please click to join the Take Action Network.

TAN also allows you to customize the information you receive. We hope that you will include actions and events from Health Care for All-Washington in your TAN list of sources.


 Editor: Elaine Cox ★ Graphics & Communications Specialist: Sydnie Jones 
  President: Ronnie Shure ★  

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