In this issue:

• HCFA-WA Goes Back to College!
• UHCC Sept. meeting
• FTAC Sept. meeting
• October Actions to Save the Healthcare Safety Net!
  • Action #1:  Tell Congress to Reauthorize the ACA Enhanced Premium Subsidies
  • Action #2:  Save Community Health Clinics
  • Action #3: Oppose Expanding Prior Authorization Into Traditional Medicare
• News You Can Use
• October and November Events

On Campus with future health care leaders: HCFA-WA goes back to college!

On September 22, members of Health Care for All-Washington participated in WashPIRG’s UW Affordable Healthcare Volunteer Fair. There were many great conversations with  students, essentially all freshmen with an interest in health care degrees. We were able to get a significant number looking at our volunteer opportunities and a number signing up for our mailing list and legislative action opportunities.

Welcome, advocates! We look forward to connecting with you soon!

HCFA-WA President Ronnie Shure sharing our mission with student

September Universal Health Care Commission Recap: Section 1333 Compacts: More Questions than Answers

By HCFA-WA Board Member Marcia Stedman 

At their Sept. 11th meeting, Commissioners heard a presentation on Section 1333 Insurance Compacts, at the request of Insurance Commissioner Patty Kuderer.

Section 1333 is part of the Affordable Care Act (ACA) and, like the ACA’s Section 1332 waivers, a state must have a law authorizing the Compact and the same guardrails around benefits and impact to the Federal budget apply.  These Compacts, if authorized, would permit the sale of health insurance across state lines and allow multiple states to offer a joint Basic Health Plan. Unlike 1332 waivers that require CMS approval, the 1333 waivers also require Congressional approval, and the hurdles are many: there is no guidance from the Feds, they have never been used, and they leave the current multi-payer insurance landscape intact, raising the question of whether they are appropriate as a tool for pursuing universal coverage. 

This program could cover a larger group of people and potentially offer opportunities for administrative simplification. However, after the hour-long presentation of limited information, Commissioners had significant questions, such as “where are the savings?” and “this would bring in more plans. Is that good for us?” Nevertheless, a few Commissioners expressed interest in meeting with their Oregon counterparts to learn more about this option. 

Takeaway #1: Universal health care advocates wonder how devoting time to Section 1333 compacts will move the Commission’s work forward, given the Commission’s severely reduced staff support and the limited amount of information available on this program.

The federal threats to health care funding caused Commissioners to take a defensive posture and prioritize these Transitional Solutions for 2026:

• protect Washington’s coverage gains
• develop mitigation and stabilization strategies
• meet rural health care workforce needs
• open the Health Benefit Exchange to small businesses
• develop a Medicare Advantage plan for WA residents who qualify

Takeaway #2: The advocate community, on the other hand, is keeping its eyes on the prize: universal health care with single-payer financing.  In public comments, they urged the Commission to prioritize governance, consider health care as a public utility, and build on studies done in past years that would build infrastructure for the new system and at the same time save money for the state:

• Consolidate and expand state purchasing of health care for PEBB and SEBB plans
• enroll local governmental entities in PEBB
• offer only standard plans on the Health Benefit Exchange
• Continue to simplify administrative requirements and prior authorizations
• offer supplemental (secondary) coverage for those health services not covered by Medicare
• take back Medicaid administration from the current Managed Care Organizations

Jump to the blog for good news from State Agencies and an update on Commission members 

View the meeting video

View the Meeting Materials

The next Commission Meeting is on Oct. 9th from 2-5 pm, when the Commission’s final version of its 2025 Report to the Legislature will be voted on. Details available here closer to the date

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 

Finance Technical Advisory Committee September 18 Meeting Recap

By HCFA-WA Board Member John Sobeck

In addition to a recap of the 1333 waiver discussion at the UHCC, the primary focus of the FTAC meeting was provider reimbursement and participation in a universal system. Expert presentations by Bob Murray and Christine Eidner outlined a phased approach: beginning with PEBB/SEBB reference-based hospital pricing at 200% of Medicare, followed by evaluation and possible expansion to local governments, then consideration of out-of-network caps for commercial markets, and eventually a transition to global hospital budgets. Critical considerations included ERISA implications, the need for rate analysis (with current Washington hospital rates averaging 250% of Medicare), monitoring provider responses to avoid negative impacts, and geographic comparisons with neighboring states to prevent provider losses. Experts recommended future speakers such as Roz Murray and Chris Whaley for reference-based pricing, Bob Berenson for physician reimbursement and primary care rebalancing, and Aaron Fuse for ERISA legal expertise.

Several decisions were reached. The Benefits and Services straw proposal will be included in the November 1 annual report, while the Eligibility proposal may be included if revisions are completed in time. The Commission reached consensus on an incremental approach to provider reimbursement starting with hospital reference-based pricing, and staff were tasked with developing a detailed framework. Future presentations will cover PEBB/SEBB implementation and Oregon’s lessons learned, and a straw proposal for provider reimbursement is expected for the December Commission meeting. Additionally, 2026 meeting dates were confirmed (all on Thursdays), the FTAC charter was amended to clarify the vacancy replacement process, and a recruitment announcement for an FTAC vacancy will be released within 1–2 weeks.

The next meeting is Thursday, November 6, 2–4:30 p.m.

View the Meeting Video

View​​ the Meeting Materials

Action Item #1: Preserve the Enhanced Premium Tax Credits  

Congress enhanced the tax credits that over 200,000 Washingtonians use to get health coverage on Washington Healthplanfinder. Small business owners, part-time and gig workers, middle-income families, early retirees, and young adults use tax credits to afford their health coverage. But these tax credits will expire at the end of the year unless Congress extends them soon. 

Tell your Members of Congress to protect health coverage for working families and stop these enhanced premium tax credits from expiring: 

Learn how this would affect Washington State

Action Item #2: Save Community Health Clinics

Community Health Centers (CHCs) across the country are saving lives and taxpayer money every day. Support the CHCs in Washington state by visiting their National Association’s website as they create a drumbeat about their value up to September 30, when federal funding expires Send a message to Congress

Action Item #3:  Oppose Expanding Prior Authorization Into Traditional Medicare

Congress is weighing action to stop the Trump administration’s WISeR pilot, set to begin in January 2026 in Washington and five other states. WISeR would raise denial rates and restrict access to needed services. Now is the moment to push back before these harmful changes take root. Email Congress about Trump’s plan to let Artificial Intelligence (AI) decide which Medicare patients get care.

THANK YOU FOR TAKING ACTION TO SAVE THE HEALTHCARE SAFETY NET! 

Our 2nd Wednesday Speaker Series returns in October!

Ending Neglect of Tuberculosis, the U-shaped curve in public health
with Dr. Stefan Goldberg
Wednesday October 8, 7-8:00 P.M. PDT

Weighed Down by Alleged Fraud, CVS’s Omnicare Files for Bankruptcy
Health Care Un-covered - Sept. 26, 2025

When Washington DC Hands Out Lemons: How States Can Cushion Medicaid Cuts
Health Care Un-covered - Sept. 25, 2025