In the bleak midwinter, glimmers of light at the December UHCC Meeting  

By Marcia Stedman 

In this season of darkness, FTAC member Bob Murray brought welcome light to the Commission’s December meeting.   Bob was the executive director of Maryland’s hospital rate-setting system and gave an extensive presentation to the November FTAC meeting.  The deep experience and interest in health policy, health economics, and rate-setting models that he brought to this December meeting was just what the Commission needed to hear.

Based on his solid contributions to this meeting, Chair Vicki Lowe suggested that there be a joint UHCC/FTAC meeting in the future. We think this is a great idea, as it could greatly improve the speed and efficiency of the system design process. 

For now, Commissioners were instructed to view the November FTAC meeting recordings on their own, available publicly on the HCA website. You too can watch the November FTAC recording that includes Bob’s complete presentation, starting at minute 47:20.   For all the details, we recommend that you also view Bob’s slides in the November FTAC Meeting Materials (pp. 51-66) and our November FTAC Recap of Costs and Cost Containment. 

Other shining stars in December’s meeting:

Evan Klein, the Health Care Authority’s Special Assistant for Legislative and Policy Affairs, gave an overview of the proposed 2025 HCA bill that addresses health care access and affordability. Against the backdrop of increasing costs, rising premiums, and increasing reimbursement rates, he noted the success of reference-based pricing and rate caps in other states seeking to lower health care costs. For example, Oregon’s adoption of reference-based pricing projected savings of over $112 million in a little over 2 years.  His presentation begins at minute 00:52 of the Meeting Recording and on page 30  of the Meeting Materials.

Dave Iseminger, Director of the HCA’s Employees and Retirees Benefits Division, noted that if this bill is successful and the reforms are carried out, the PEBB/SEBB programs that he manages could become more attractive to other state agencies and local governments, leading to market consolidation that would in turn facilitate the universal system, which is, of course, the goal of this Commission.  The Commission’s vote to support this bill was nearly unanimous, with Rep. Schmick voting no and citing the need for more information.  

Jane Beyer, representing the Office of the Insurance Commissioner, aptly summarized the discussion topics for the benefit of her colleagues and the public. The incoming Insurance Commissioner, Patty Kuderer, is a strong supporter of single-payer universal health care and intends to be involved and present at many of the upcoming Commission meetings.

Mohamed Shidane’s repeated pleas to pick up the pace of the work resonated with other Commissioners who agreed by consensus to focus on the universal system design during the Legislative Session and leave the transitional solutions to the Legislature.  After Session, they will continue to spend 50% of their effort on the system design.

In another remedy along the same line, after more than a year of agreeing to send presentations to the Commission in advance of their meetings, HCA staff committed anew to doing so and in a timelier manner.  Staff will also send time-stamped FTAC videos and a brief summary of each FTAC meeting well in advance of the next UHCC meeting, so that Commissioners will be prepared to discuss and make decisions.

The Milestone Tracker (see p. 62 of the Meeting Materials), another of Mohamed’s requests, is now a reality.  Based on the yearly Work Plans, it reveals the slow pace of the Commission’s system design work.  Numerous presentations have been made on eligibility, benefits, cost-containment, and provider issues.  Yet all of these are still “in progress,” despite the “completed” designation for eligibility. 

In his public comment, universal health care advocate David Loud noted that decisions have not been made on a variety of situations impacting eligibility, including voluntary enrollment, automatic enrollment at birth, the definition of all residents, residents temporarily out of state,  who work in another state or who live in another state but work in Washington, those who need specialized care in another state or country, and veterans who do not qualify for Veterans Administration services.   Most of these situations are accounted for in the latest iteration of HCFA-WA’s Washington Health Security Trust proposal. We look forward to presenting it to the Commission in early 2025. 

In closing, David recommended that the Tracker be accurate and that every update be date-stamped.

The meeting concluded with the Commissioners identifying their key interests for 2025

• Further consideration of reference-based pricing
• Exploration of the public utility model for health care
• Data and enforcement mechanisms
• Negotiation of pharmaceutical drugs
• A review of the administrative code for places to save money and improve access to timely health care
• An in-person meeting sometime after Session

Next up in the UHCC/FTAC series is the FTAC meeting on Thursday, January 16, 2025, 2-4:30. 

Meeting links and materials will be available soon after the New Year.

The next UHCC meeting will be held on Thursday, February 13, 2025, 2-5 p.m.

Meeting links and materials will be available soon after the New Year.

Join us as we track these meetings. 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 (below)
• Subscribe to Health Care Authority (HCA) for updates.