State Legislation

Great news! 

E2SSB 5399 is now law and the universal health care commission is a reality!  

Thanks to all who supported this bill. Whether you signed in support of this bill, or you submitted written or live testimony, you made a difference, and in record numbers! Legislators were absolutely paying attention to the increase in citizen engagement through remote testimony! We need to make sure that this option remains even after the state government resumes fully in-person proceedings.

The legislative session bloomed with many important health care bills becoming law. We’re beyond thrilled about the passage of E2SSB 5399, which creates a permanent universal health care commission with timetables to ensure that we are on track to implement universal health care. This law, prime-sponsored by Senator Emily Randall (26th LD), will lay the administrative and financing foundations for universal health coverage in Washington. In other words, the law provides the “nuts and bolts” of how universal health coverage will work—everything from benefit packages, reimbursement rates, and financing mechanisms, to transition plans, and more--with billions of dollars in annual savings projected. Imagine that! Covering everyone for less money.  

THIS IS A BIG DEAL …….  So, what’s next?

The law specifies that the commission must hold its first meeting within 90 days of enactment. Within this timeframe, the Governor must appoint six individuals and a chair. We’re developing a list of appointees who support state-based, publicly funded universal health coverage (Model A from the UHC Work Group) and who have extensive leadership experience and/or background in Washington State health policy. Thanks to the generous contributions of supporters like you, our lobbyist Cindi Laws is now on the job and working to advance our preferred candidates to the Governor! 

But wait, there's more!

HCFA-WA is also celebrating these other new laws that will inform the commission's work:  

E2SSB 5377 – Increasing affordability of standardized plans on the individual market 

This law increases the affordability of standardized plans offered on the Washington Health Benefit Exchange by lowering premiums and expanding access to health care insurance. As a result, an additional 24,000 uninsured Washington residents will be able to afford health insurance.

The use of private insurance inflates health care costs by putting “profits over patients” with excessive administrative costs. So, we are encouraged that this bill both requires insurers to improve access to health insurance statewide and controls reimbursement to reduce costs. 

ESSB 5203 - Producing, distributing, and purchasing generic prescription drugs

This law expands the existing Prescription Drug Purchasing Consortium by allowing the state to enter into partnerships with other states, groups of states, and non-profit organizations. These partnerships will enable the production, distribution, and purchase of generic drugs and insulin.

This law lowers the price of prescription drugs by allowing a public agency to compete with private pharmaceutical companies and Pharmacy Benefit Managers.  

E2SHB 1272 – Promoting health system transparency 

This law has requirements that address the following three components of health care systems:

• Financial: The law requires detailed financial reporting to uncover the true cost of healthcare needed to establish sustainable pricing levels. It also protects patients from hidden fees by requiring clinics to notify patients of fees that will not be covered by insurance if they are referred to an off-campus clinic for non-emergency care.   

• Staffing: The law requires staffing plans and facility layouts that enable nurses to take meal and rest breaks.

• Data: The law requires hospitals to include information about patient demographics such as race, ethnicity, gender identity, sexual orientation, preferred language, any disability, and zip code. Disaggregating this data is very important. For example, a Somali-born African American can have a very different set of issues accessing care than an African American who was born in the USA. By requiring providers to collect data that differentiates by language between an African American born in the USA, and one born abroad, we can better understand the unique challenges that each of these communities faces. 

E2SSB 5052 - Creating health equity zones  

To address the undue burden that diseases place on vulnerable communities, this law designates health equity zones and funds the communities who live in them to develop projects to improve and monitor their health outcomes.

Community-driven, place-based efforts to reduce health disparities in the most vulnerable populations have been shown to be very effective. Universal health coverage is necessary, but not sufficient, to achieve health equity.

Federal Focus

“Healthcare should be a right, not a privilege, in America.”
It was encouraging to hear President Biden say these words in his recent “100 Days” speech to Congress and the American people. We at HCFA-WA have been saying this for years.  Currently, the Administration’s preferred solution to America’s health care crisis is to make the premium subsidies on the Affordable Care Act marketplaces permanent. This is a small step that will help some. But what is needed is a giant leap to transform our health care system to help all of us.

Subsidizing the Insurance Industry with Premium Subsidies

In effect, these expanded ACA subsidies would continue to transfer taxpayer dollars to the for-profit insurance industry, while doing nothing to lower overall health care costs like insurance deductibles and skyrocketing pharmaceutical drug prices. There is a better way.

If Health Care is a Right, Let’s Make it a Public Good

Senate progressives, led by Bernie Sanders, call for enhancing Medicare benefits by lowering the Medicare eligibility age from 65 to 55 or 60 and providing dental, vision, and hearing care to those already on Medicare. This is a step toward the transformative change that our health care delivery system so sorely needs! 

While the Feds Dither, Washington State is Moving Ahead on Universal Health Care

With the universal health care commission, Washington is poised to become the first state in the nation to provide health care as a public good for its residents. But the devil is in the details, and when it comes to health care, those details have a lot to do with the financing mechanism. Fact: the robust funding needed for an effective state-based, publicly funded universal health care plan depends on federal cooperation and support. 

Support for the State Based Universal Health Care Act (HR 5010)

That’s why HCFA-WA is excited about California Rep. Ro Khanna’s State-Based Universal Health Care (SBUHC) Act, slated to be re-introduced in Congress this June, identical to last Session’s bill, but with a new number. Waivers available now under the Affordable Care Act’s Section 1332 allow states that have created a universal public plan to apply for access to federal funding and support for their plan. Rep. Khanna’s SBUHC Act builds on the ACA by adding a new 1335 waiver option for those states. The following table compares the two waivers.  

What is the difference	SBUHC Act 1335 Waiver	ACA 1332 Waiver
Allows states to integrate Medicare funds into their state plan	YES	NO
Grants access to ERISA Waiver to prevent self-insured employers from opting out of state plan	YES	NO
Allows multi-state regional plans	YES	NO
Requires state plans to cover 95% of residents within 5 years	YES	NO
Waiver Application Decisions	Independent Assessment Panel appointed by HHS Secretary to review and recommend	Leaves waiver decisions with the HHS Secretary alone

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State Action for 5399 

Thank your legislators for passing 5399 and Gov. Inslee for signing 5399 into law. Click on the link to find your legislator.  You can say: “Thanks so much for making Washington state a leader in universal health care.”

Federal Action on the SBUHC Act

Our meeting with Representative del Bene: Recently, HCFA-WA President Marcia Stedman partnered with David Loud and Nathan Rodke of Health Care is a Human Right - Washington to prepare for a meeting with the staff members of Congresswoman Suzan DelBene (1st CD). Six constituents shared their personal health care experiences and support for publicly funded universal health care. We asked Rep. DelBene to sign on as an original co-sponsor of the SBUHC Act.  

Like Pres. Biden, Rep. DelBene’s preferred solution is to expand the ACA subsidies. We did not secure her support at this time. However, we did increase her awareness of this important measure. We hope to continue our conversation directly with the Congresswoman herself next time.

Currently, Washington state co-sponsors include Rep. Pramila Jayapal and Rep. Adam Smith.

Where Does Your Congressperson stand?

Click here to contact your Member of Congress and tell them why you want them to sign on as a co-sponsor of the SBUHC Act.  

Personal stories are best! You also can use the following message: “Please sign on as a co-sponsor of Rep. Ro Khanna’s State-Based Universal Health Care Act.  It is an important next step for a Washington state universal health care system.” 

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Presentations

We are fortunate to have two presentations to share. 

Dr. David Belk: The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda have Exploded Healthcare Costs in the U.S.  

Our April Public Meeting featured a presentation by Dr. David Belk, board certified in Internal Medicine with a private practice in Northern California. Over the last 10 years, he has devoted most of his free time to untangling and demystifying health care costs in this country.  

The results are documented on his website, The True Cost of Healthcare, and in his highly acclaimed book, "The Great American Healthcare Scam.”  We are extremely grateful to him for sharing his findings with us. 

Main takeaways:

Medical bills are works of fiction. The average medical bill is discounted (adjusted) by about 70 percent to 80 percent, and hospitals and other medical providers in the U.S. bill an average of 3 to 5 times more than what they expect to be paid. 

Overbilling is built into the healthcare system. Due to lack of transparency, no one knows the true cost of healthcare in the U.S. If you have no idea how much something should cost, you’ll never know when you’re being overcharged! 

Health insurance is a protection racket.  It “protects” patients from fictitious overbilling that is based on artificially inflated prices, prices that the insurance companies have no incentive to control. As “universal middlemen,” insurance companies benefit from higher health care prices as they keep a cut of everything that passes through them. The more it costs, the more they keep.

Pharmacy Benefit Managers do not benefit patients.  They have no incentive to rein in prices as they work together with drug manufacturers to determine both the price and the availability of the drugs your doctor prescribes. Here again, the higher the price, the more the patient pays and the higher the manufacturers’ and benefit managers’ profit. 

Most employers have been scammed more than anyone.  They have been talked into signing Administrative Service Contracts (ASC), where, for a set fee, the insurance company handles claims processing, organizes provider networks, and manages other health plan logistics, but provides the employer no accounting for the actual services that are billed in their name. In effect, under an ASC, the employer assumes responsibility for all the risk and is liable for all financial elements of the plan.

Medicare Advantage and Supplemental plans are a rip-off. If you want to hit insurance companies where it hurts them, and you want to save Medicare, tell everyone to not buy Medicare Advantage or Medicare Supplemental plans. 

Click here to buy Dr. Belk’s book

Dr. Stephen Kemble:  Insurance Industry Trojan Horses Bearing Risks

Dr. Kemble explains the vagaries of risk-bearing and the problem of risk-bearing loopholes being inserted into single-payer health care legislation. First 19 min.: Dr. Kemble's presentation. Last 70 min. Q&A. Click HERE to view.

Dr. Kemble is a psychiatrist in private practice and Assistant Clinical Professor of both Medicine and Psychiatry at the University of Hawaii School of Medicine. He has a longstanding interest in health care reform, and has been appointed to the Hawaii Health Authority, charged with overall health planning for the State of Hawaii, and with designing a universal health care system covering everyone in the State. Dr. Kemble serves as a board adviser to Physicians for a National Health Program.

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Health Care Bill Of The Month  - Kaiser Health News and NPR

US: Include Maternal Health in Climate Change Action – Human Rights Watch 

Senate Finance Committee Releases Insulin Investigation Results – Policy & Medicine

E2SSB 5399 in the News:
Washington State: Single-Payer Health Care Here We Come  - OpEdNews.com

OPINION: State bill on universal health care is advantageous for all residents – The Daily Evergreen

Washington Quietly Passed One of the Strongest Universal Health Care Laws in the Country  - The Stranger