By Marcia Stedman
Haunted by the specter of looming budget shortfalls, the Universal Health Care Commission (UHCC) continues to delay the creation of the universal system that would achieve significant savings for the state and at the same time deliver comprehensive health care to all residents.
E2SSB 5399, the enabling legislation that established the Commission in 2021, clearly states that “Multiple economic analyses show that a universal system is less expensive, more equitable, and will produce billions in savings per year.” Yet despite this common knowledge, the Commission refuses to act on the findings of the Universal Health Care Work Group that proved this very point.
In contrast to recent meetings, this October 2024 meeting was well attended with 10 of the 14 current members present, resulting in robust and thoughtful discussions, and the ability to take votes on two matters, both of which passed:
- recommend continued funding for the Apple Health (Medicaid) Expansion
- approve the Commission’s 2024 Annual Report to the Legislature
Main Topics and Takeaways:
Cost-sharing Principles:
Some patient cost-sharing is assumed, but to do dynamic modeling of zero cost-sharing, more funding is needed.
Regrettably, the nearly $500,000 for dedicated support staff and actuarial expertise for 2024 was won by the advocate community in 2023 but was misapplied by the Health Care Authority, causing a significant delay in the Commission’s work.
Apple Health Expansion:
The motion passed, but the two Legislators present abstained, citing responsibilities to advocate for social programs other than the Commission, and the need to spend the money on helping the currently enrolled rather than continuing to expand the program.
Prior Authorization Discussion:
- Takeaway #1: Standardizing the forms is difficult when you have so many payers (insurers) with a variety of criteria, leading to treatment delays and administrative burden
- Takeaway #2: Managed care plans are the ones most often requiring Prior Authorization, which increases the administrative burden on providers
State Agency Report Outs : There were no printed reports but the verbal reports are viewable on the meeting video at 1 hr:03 min.
- Dept. of Health - access the J-1 program for 5-yr visas for foreign medical professionals
- Health Benefit Exchange - Auto-enroll those losing Medicaid coverage to the Qualified Health Plans on the Exchange*
- Health Care Authority – consolidate purchasing for the PEBB/SEBB program*
- Dept. of Social & Health Services - expand access to Medicaid for low-income Medicare beneficiaries*
*Health Care for All-Washington secured the funding for the studies that investigated these transitional solutions that were identified by the Commission last year. We hope that the Reports, due by December 2024, should result in 2025 Legislation.
The Insurance Commissioner’s Final Report on Healthcare Affordability
Main Takeaway: greater affordability leads to greater access and savings to the entire state
- Establish a reinsurance program for individual and small group markets
- Increase the share of premiums that insurers must spend on medical care for their enrollees
- Use reference-based pricing
- Use hospital global budgeting
- Meet the Health Care Cost Transparency Board targets
The video begins at 1hr:45min. See page 116 of the Meeting Materials for more information on these options to make health care in Washington more affordable:
Join us as we track the next meeting of the UHCC on Thursday, December 5, 2024, 2-5 p.m.
The next FTAC meeting will be held on Thursday, November 14, 2024, 2-4:30 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