Universal Health Care Commission

Mark your calendar for the next meeting

Next UHCC meeting | Next Finance Technical Advisory Committee (FTAC) meeting

What does the Universal Health Care Commission do?

Creates immediate and impactful changes in health care access and the delivery system in Washington.
Prepares the state for the creation of a health care system that provides coverage and access for all Washington residents through a unified financing system, once the necessary federal authority has become available.
Submits annual reports to the Legislature each November.

What is HCFA-WA’s impact?

We actively support the work of the UHCC through our relationships with allied organizations and UHCC members.
We recommended five of the six public members of this 15-member body, including the Chair, Vicki Lowe. Click here to learn more about Commission members.
We submit live and written public comments.
We provide links, updates and recaps of the meetings.

Meet the Commission members at our 2nd Wednesday Speakers Series.

What you can do:

Tell us why universal health care is important to you and what you would like the UHCC to know.
Subscribe to Health Care Authority (HCA) for updates.
Sign up to provide public comment by 5 p.m. the day before a UHCC or FTAC meeting occurs.

The Latest:

All hands on deck at the October Universal Health Care Commission Meeting!

Solid Suggestions from the Advocate Community at the Oct. 9th UHCC meeting illustrate the need for an “all hands on deck” approach to protect access to health care for Washington residents.

HCFA-WA President Ronnie Shure proposed four transitional solutions: consolidating PEBB/SEBB purchasing; promoting local government enrollment in public employee plans; supporting limitations on corporate practice of healthcare; and allowing the Health Benefit Exchange to offer only standardized cost-sharing plans to increase competition and reduce administrative workload.

Whole Washington volunteer Thomas Kennedy described their work on approximately 12 bills ranging from PEBB/SEBB consolidation to a constitutional amendment for healthcare, emphasizing the need for "deprivatization plans" for publicly administered programs and stronger coordination between advocacy groups and the Commission, building on the advocates roundtable model.

Annie Fitzgerald, a Grassroots Disability Justice Organizer, speaking from lived experience as a disabled person from Snohomish County, urged the Commission to include quarterly advocates roundtables in the 2026 workplan, emphasizing that disabled people, caregivers, and community advocates bring essential knowledge about system failures and real solutions, ensuring the universal healthcare plan is inclusive, accessible, and rooted in justice.

Julia Shake, Washington CAN Healthcare Intern, shared her personal story of her mother losing health insurance during the pandemic because her father's income slightly exceeded Medicaid's threshold. Federal funding cuts make the Commission's work urgent. She called for transitional solutions such as administrative simplification to reduce overhead and stronger price controls to make healthcare affordable without forcing choices between health and survival.

Paul Ryan Villanueva, Asian Pacific American Labor Alliance Seattle Chapter, emphasized healthcare access difficulties in immigrant families and expressed concern about recent incidents where healthcare data was given to Homeland Security for immigration enforcement, calling it a betrayal of trust. He requested the Commission hold more advocacy roundtables and consult organizations representing marginalized workers and unions, arguing healthcare issues cannot be separated from worker and immigrant issues.

Mahati Alapati, Whole Washington Advisory Board Member, focused on how federal and state Medicaid cuts affect university students, including new work requirements of 80 hours monthly, reduced eligibility for non-citizens and international students, and six-month reenrollment frequencies. Many students aren't enrolled for sufficient hours, university funding cuts make student employment scarce, and the average graduate student age of 32 exceeds parent insurance coverage limits.

Katherine Lewandowsky, Whole Washington Board Vice Chair and Registered Nurse, reported on a recent Whole Washington town hall in Omak (CD4), where residents face high uninsured rates, heavy Medicaid enrollment, and hospitals at risk of closing due to federal cuts. She shared a recommendation to adjust the Washington Health Trust's business assessment sliding scale and concerns about large corporations like Walmart forcing low-wage employees to pay the 2% employee healthcare share while avoiding providing insurance coverage.

In other business, the Commissioners received State Agency reports and approved their Draft 2025 Report to the Legislature, as well as significant Work Plan changes for 2026, and ongoing Transitional Solutions.

State Agencies and Federal threats to Washington’s health care safety net

Joan Altman of the Health Benefit Exchange: 300 DACA childhood arrivals already lost their premium subsidies as of Oct. 1, 2025; 10,000 Exchange customers will lose their premium subsidies on Jan 1, 2026; and 15,000 more will do so in 2027, if the Federal Enhanced Premium Subsidies are not extended.

Jane Beyer of the Insurance Commissioner’s Office: In a bi-partisan action, all 50 state Insurance Commissioners have asked Congress to extend the premium subsidies.

Dr. Tao Kwan-Gett of the Dept. of Health: the West Coast Health Alliance (WA, OR, CA, HI) is following the vaccine guidance of the American Academy of Pediatrics - not the new Federal guidelines - for COVID, flu, measles (MMR) and RSV. The standing order is just a prescription, not a mandate, and parental consent is required.

Dave Iseminger of the Health Care Authority: the HCA is in the process of setting the rates for the reference-based pricing bill 5083 that passed the Legislature earlier this year.

Vicki Lowe, Executive Director of the American Indian Health Commission of Washington and Chair of the UHCC, is pursuing Rural Health Transformation Grants and rural hospital global budgets.

Three votes move the Commission’s work forward.

The Commission voted nearly unanimously to approve the Eligibility Straw Proposal, to include the Proposal in the 2025 Report to the Legislature, and to approve sending the full Report to the Legislature. Curiously, despite his impassioned plea for Commissioners to think about the service cuts that will be necessary at a hospital in his district facing an $80 Million budget shortfall, Rep. Joe Schmick voted “nay” on all 3 proposals. View the draft 2025 Report to the Legislature on pages 56-106 of the Meeting Materials

Work Plan Changes for 2026

In a major structural shift for 2026, the UHCC and FTAC will move from the current sequential back-and-forth workflow to parallel workstreams with distinct responsibilities for different bodies.

The Commission will focus on interim solutions, prioritizing projects that could serve as pilots for eventual universal design elements, and drawing on the work of other boards and programs, such as the Rural Health Transformation Program and the Health Care Cost Transparency Board, among others.

The FTAC will continue to consider provider reimbursement, guiding principles for the universal system, and financing. After making its recommendations in these areas, the FTAC is expected to sunset in 2026, when an Operations Committee will be formed to deal with enrollment and designing the infrastructure and governance models.

Transitional Solutions – see p. 53 of the Meeting Materials

The discussion that followed indicated the Commissioners had listened closely to the Advocates’ public comments, as they proposed

More structured engagement with advocacy organizations, labor groups, and marginalized communities, and potential collaboration with advocacy groups on joint town halls/listening sessions
Reaching out to advocacy groups such as HCFA-WA for the guiding principles in the Washington Health Security Trust (WHST)
Looking at pilots and models from other states, e.g. Connecticut’s experience in taking back their Medicaid administration from Managed Care Organizations.
Prioritizing addressing rural health needs, as presented by the rural health panel at the February UHCC meeting. Read our recap of that meeting
Addressing administrative simplification to bring down the cost of health care for the state, providers, and patients.
Labor Union support could be gained by restarting the Small Business Health Options Plan (SHOP) that closed in 2017 due to slow uptake.

Both UHCC Chair Vicki Lowe and conservative Rep. Joe Schmick expressed a need to bring health care dollars into our state, which could be accomplished by establishing a state-option Medicare Advantage plan, designed to correct for the negative aspects of these plans.

Despite covering a wide range of topics in substantive discussions, the meeting adjourned 38 minutes earlier than scheduled. The next Commission meeting on Thursday, Dec. 11th, from 2-5 p.m. will feature a labor panel.

The FTAC meets next week on Thurs., Nov. 6, from 2-4:30 pm. 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.