2nd Wednesday Speaker Series: Transforming Public Will into Political Action with Vincent DeMarco

By Consuelo Echeverria

Vinny is a tenacious and effective public health advocate in Maryland known for his long-term campaigns and coalition-building to pass legislation on issues like gun control, tobacco taxes, healthcare access, and clean energy. He is the President of the Maryland Citizens' Health Initiative (also known as Maryland Health Care for All!). He has been praised for his authenticity, compassion, and ability to mobilize diverse groups behind public health policies. In this presentation, he shares his general template used to organize the public to get specific legislation enacted successfully. His "Six Steps for Effective Advocacy Campaigns" is entertaining, engaging, and, above all, EFFECTIVE! Here is the link to his presentation. 

2 quick actions: 

Tell Congress to support Rep. Ro Khanna’s State Based Universal Health Care Act (SBUHCA, HR 6270).  This Act will provide important support to states like ours that are working to create comprehensive health plans for all their residents, leading the way to an equitable, universal, simple, affordable (USA), national health plan.  Goal: 50,000 signatures. To date: 11,000. Please Sign the petition now.  Deadline: June 21st.

Call on Senators Murray and Cantwell to become co-sponsors of the Senate Version of the State-Based Universal Health Care Act.  For the first time ever, there will be a Senate bill, cosponsored by Senators Ed Markey and Elizabeth Warren. Our partners at One Payer States, along with advocates across the country have made great progress in advancing the federal State Based Universal Healthcare Act. Now we need more original cosponsors and supporters and that’s where you come in. Click here to ask our two US Senators to sign on!

May FTAC Meeting: How does a health plan figure out the cost of its product?

By Consuelo Echeverria

This month, the Finance Technical Advisory Committee (FTAC) dove into a consideration of how much it costs Washington state to deliver health care.

The presentation by FTAC member David DiGiuseppe, Vice President of Healthcare Economics for the Community Health Plan of Washington, began with the disclaimer that he was speaking not in that capacity, but as an individual.  Nevertheless, his presentation was largely an explanation of how insurance plan administrators structure their product, as he explored how  Benefit Design [what services are covered] + the cost structure [the cost of providing those services] = cost of care for the state.  He proposed a few very broad models to visualize the cost of care for the state as a framework for an actuarial study. There are five models: 1. self-funded model, 2. large group, small group and individual insurers, 3. Medicare, 4. Medicaid, and 5 the Single Payer model as outlined in bills proposed by Whole Washington (SB 5335) and Health Care for All-Washington. 

Mr. DiGiuseppe stated that utilization and prior authorizations also impact the cost of care, because obviously if prices go down, more people are more likely to use a service. Prior authorizations then can be used to control utilization. The other thing that we have to think about is who we serve and how a change in the demographics of a population, for example aging, pregnancy, etc..  impacts utilization, benefit design and cost structure. Finally, we came to the market dynamics impact on costs and the individual decisions on price, network, benefits, and services for consumers.

His presentation is worth listening to as he lays out a very nice framework for looking at various health care models and we can start to play with the various components to visualize what health care might look like in WA. As you watch the meeting, please note that the figures he uses are rough estimates as he did not drill down to get the true amounts. His presentation on the video is from 29:40 to 1:44:00, including a very good discussion after.

A highlight of the meeting was the memo submitted by FTAC member Roger Gantz, Senior Research Manager (retired) at the Dept. of Social and Health Services.  It clearly provides an excellent framework for the actuarial analysis that will soon, we hope, be undertaken as requested by the Universal Health Care Commission. His memo was referenced at approximately 1:00:00 into the recording and is included in the meeting materials, (p. 51-57).

Other highlights

1. Bring key legislative staff into the modeling discussion to bring a degree of credibility and understanding of the strengths and weaknesses of various options when it is brought to the legislators. 
2. The impact of eliminating cost-sharing on the state’s total cost of care was discussed

Read more, including “Lowlights” and updates from the Health Care Cost Transparency Board 

Join us as we track the next meeting of the UHCC next Tuesday, June 4, 2024, 2-5 p.m.

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
• Subscribe to Health Care Authority (HCA) for updates.