Health care Politics Washington State Politics

Competing bills for universal healthcare in Washington State

Two bills to establish universal health care in Washington State are under consideration by the state senate this session.

The Whole Washington’s Health Trust (SB 5204), sponsored by Senators Hasegawa, Kuderer, Liias, Lovelett, Nguyen, Stanford, and Wilson, C., “is fully realized, universal healthcare legislation, complete with specific funding mechanisms and a transition plan. If passed, Washington State residents could have comprehensive healthcare by 2023”  — quoting from email sent by the Washington Bernniecrats Coalition.

A competing bill Concerning the creation of a universal health care commission (SB 5399) will create a commission to study universal health care but won’t implement one yet.  The sponsors of SB 5399 are Senators Randall, Cleveland, Das, Dhingra, Frockt, Hunt, Kuderer, Liias, Lovelett, Nguyen, Nobles, Robinson, Saldaña, Stanford, Van De Wege, Wellman, Wilson, C.

Notice that several senators sponsored both bills.

Quoting again from the email from the Washington Bernniecrats Coalition

Washington voters don’t want another commission. We just spent $500,000 on a study that determined a publicly-funded bill would save money and cover more people. We don’t need another study! We’re deep in a pandemic, and what we want is action. Why study our broken system, for a chance at reform to possibly be implemented by 2026, when passing SB 5204 would mean universal healthcare starting in 2023?

Senate Health Committee Chair Annette Cleveland says  she will deny the first bill, SB 5204, a hearing. Instead, she will allow a hearing on the second bill, SB 5399.

The South Seattle Emerald has an informative article about the first bill, SB 5204:

The bill would create a board of trustees — appointed by the governor and nominated by the legislature and insurance commissioner — who would design an essential benefits package to cover Washington residents and manage the trust.

This benefits package is intended to provide primary, preventative care, and would constitute “minimum essential coverage” under the Affordable Care Act. The goal is that it would cover more than Medicare, including cheaper prescription drugs, dental, and vision coverage.

The board would negotiate the prices that residents would pay for pharmaceutical drugs so that they wouldn’t need to pay more than $250 per year, and preventative drugs would be exempt.

The bill would not directly eliminate the private health insurance market. Employers could choose to pay into the Whole Washington Trust Fund or their employee’s healthcare accounts. People could access additional health benefits beyond what the basic plan offers if their employer or another plan offers it.

The Emerald article quotes Hasegawa as saying, “The likelihood of it passing, frankly, is very small.” The point is that universal coverage “gets to the top of people’s minds.”

I asked Dr. Sarah Weinberg, a health care activist, about the two bills. She gave me permission to publish her reply, below:

I was a member of the Universal Health Care Work Group. SB 5399 is an appropriate next step. Making a major change like eliminating private health insurance, keeping all the huge amount of federal tax dollars that pay for health care in our state, and raising enough state funds to make up the difference is not going to happen instantaneously. The right time to come forward with the Whole Washington Trust bill, as well as the Washington Health Security Trust bill [HB 1104], is AFTER SB 5399 becomes law and the universal Health Care Commission begins its work. THEN, we should present these two slightly different proposed plans that can make the UHCC’s work easier to accomplish.

Opposing SB 5399 hoping for passage of SB 5204 is unlikely to get us where we need to go. Instead, if SB 5399 fails to pass, all the work of the UHCWG is likely to go for naught.

The Washington Health Security Trust bill that Dr. Weinberg refers to is SB 1104 — Requiring the submission of a waiver to the federal government to create the Washington health security trust. — which has been under consideration by the legislature since at least 2015 (HB 1025). The summary of the the billfrom 2020 reads:

Creates the Washington health security trust to provide coverage for a set of health services for all residents. Requires the joint select committee on health care oversight to contract for an actuarial analysis of the funding needs of the Washington health security trust and recommend a funding mechanism to the appropriate legislative standing committees and the governor. Directs the legislature to enact legislation implementing the recommendations of the joint select committee during the 2020 regular legislative session. Creates the reserve account, the displaced worker training account, and the benefits account. Provides contingent effective dates.

As you, know health care policy is complex, with many stakeholders and a lot of money involved.  Rushing with a bill that’s not ready for passage can lead to a set back — as happened with voter initiatives such as I-1098 to raise progressive taxation in 2010.   Can’t the legislature consider both bills?  But the legislature’s time is limited, and the commission would be unnecessary if SB 5204 passes.

I will add information to this article as I learn more.

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