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May FTAC Meeting: Should governance be just an afterthought?

This 15th meeting of the Commission’s Finance Technical Advisory Committee (FTAC) opened with a rich discussion around whether the topic of Governance should be tackled sooner rather than later in the Commission’s Work Plan. Some FTAC members recommended against it, stating that doing so would “slow the work.” However, others noted that previous work already done on Governance could inform the Commission’s decisions in this area. No vote was taken, nor did the FTAC reach a consensus on whether Governance should be moved from Phase 3 work to Phase 1, as many experienced universal health care advocates have recommended. As with all other major decisions, the Commission is in the driver’s seat on this one as well.

Illustrating the actual slowness of the Commission’s work, the primary focus of this meeting was an analysis of the past three years of Universal Health Care Commission directives concerning patient cost-sharing, provider reimbursement, and eligibility. Many hours have already been devoted to these topics and others. Notably, the Commission has considered "eligibility" settled for nearly a year.  FTAC liaison David di Giuseppe led a robust discussion that clarified decisions already made and identified areas needing the Commission’s review in order for the work of designing the universal health care system to proceed.

The meeting closed with a review of Cost Containment Mechanisms and a Health Care Cost Board Report.  There was broad agreement that Cost Containment is not a separate element in a system, but rather a necessary component of all other system design elements.  The Cost Board Report focused on hospital pricing as it documented the steep rise in hospital outpatient costs from 2017-2023. Going forward, the Cost Board plans to move from data collection toward specific policy recommendations. Their work is expected to inform the work of the Universal Health Care Commission, as stipulated in the law that created the Commission four years ago.  We invite you to watch the meeting video here.

As usual these days, state and federal budget constraints and uncertainty loomed in the background. If the Federal threats to the Medicaid program and the Affordable Care Act subsidies are carried out, hundreds of thousands of Washington residents will lose health care coverage. Unfortunately, the current Washington state budget will not be able to mitigate the negative impacts of these sudden disruptions to care. 

Main Takeaway: Now more than ever, we need the cost savings that a universal publicly funded system would bring to the delivery of healthcare in our state. 

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