We’re pleased to report that all 3 of our budget provisos supporting universal health care made it into the Supplemental Budget.  

The studies and data provided by this funding will help to develop infrastructure and capacity to unify our healthcare system and meet federal waiver requirements. 

Continuing Health Care Coverage for Low-Income Individuals Who No Longer Qualify for Medicaid 
$300,000 for a Health Benefit Exchange (HBE) study on transitioning those losing Medicaid coverage onto other no-cost or low-cost HBE plans to ensure they are covered.

Why it is important 

• This study is intended to address the immediate needs of those 300,000 residents who may be at risk of losing their health insurance after the Covid-19 public health emergency was lifted. 

Improving Efficiency in State Purchased Health Care Programs
$100,000 for the Health Care Authority to provide specific information on the costs of improving efficiency in the PEBB/SEBB benefit administration. 

Why it is important 

• This study and the subsequent consolidation are important steps to prove to the federal government that WA state has the capacity to administer its own healthcare plans which is needed to successfully win a federal  waiver. We need to keep the pressure up until this consolidation actually occurs.

Expanding Access to Medicaid for Low-Income Medicare Beneficiaries
$90,000 for the Dept. of Health and Social Services to provide the legislature with the costs of expanding access to Medicaid for low-income Medicare beneficiaries.  

Why it is important 

• This study is intended to address the needs of up 70,000 additional Medicare beneficiaries whose income exceeds the existing state limit.  It would allow seniors and those with disabilities access to Medicaid medical and long-term care services.

Five of our priority bills passed - 871 Action Alerts Taken

Thanks to the amazing support by all who weighed in on these important bills!

HB 1508 Improving consumer affordability through the health care cost transparency board.

Sponsors:  Macri, Riccelli, Simmons, Fitzgibbon, Berry, Alvarado, Bateman, Ormsby, Doglio, Reed, Callan, Stonier, Tharinger, Bergquist

What this bill does:   

• Expands patient voice and adds labor and small business representatives to the advisory committee. 
• Expands data collection to include: 
  • Prescription drugs on the market for 7+ years.
  • Financial earnings of health care providers and payers, including profits, assets, accumulated surpluses, reserves, and investment income.
  • Analysis of underinsurance in Washington. 
  • Additional committees for next steps after data collection.
• Allows data sharing between other Boards and state agencies.
• Requires a public hearing each year to discuss the growth in total health care expenditures in relation to the health care cost growth benchmark and identify payers or health care providers whose health care cost growth exceeded the health care cost growth benchmark.

Why it is important 

• Makes the board more  inclusive by adding additional representative voices.
• Requires annual public hearings with opportunity for public comment.  

HB 1957 Preserving coverage of preventive services without cost sharing.

Sponsors: Riccelli, Macri, Ryu, Leavitt, Senn, Reed, Ormsby, Callan, Doglio, Fosse, Goodman, Lekanoff, Wylie, Pollet, Davis

What this bill does: 

It protects these services from cost-sharing:

• Immunizations for diphtheria, hepatitis, influenza, and measles.
• Children’s screenings for lead exposure, oral health, vision, and autism.
• Screenings for blood pressure, cholesterol, diabetes and HIV.
• For pregnant women, screenings for gestational diabetes, maternal depression, and preeclampsia.
• Pre-exposure prophylaxis HIV medication.
• Cancer screenings, including breast, lung, and colorectal cancer.
• Contraception for women.

Why it’s important:

• It ensures equity and access to preventative care services. 
• It aligns Washington state with the rest of the country. 

SB 5986 Protecting consumers from health care service charges for out-of-network ground ambulance services.

Sponsors: Cleveland, Muzzall, Hasegawa, Kuderer, Mullet, Nobles, Randall, Salomon, Valdez, Wellman

What this bill does:

• Prohibits balance billing for out-of-network ground ambulance services and addresses coverage of transports to treatment for emergency medical conditions.

Why it’s Important:

• Aligns WA state law with the Federal Surprise Billing law.
• Emergency services do not need prior authorization & are provided regardless of the network status of the emergency service.
• Emergency medical conditions include all medical, mental health or substance use disorder crises. 

SB 5213 Concerning pharmacy benefit managers.

Sponsors: Kuderer, Short, Cleveland, Conway, Dhingra, Rolfes, Wellman, Wilson, C.

Companion Bill: HB 1253

What this bill does:

• Requires registration and contract filing with the OIC.
• Prohibits PBMs from
  • Requiring use of a mail order pharmacy, except for specialty drugs. 
  • Engaging in special  pricing.
  • Excluding a pharmacy from the network based on the time the pharmacy has been open.
  • Denying or reducing payment to a provider for a provider-administered drug on the basis that the provider obtained the drug from a wholesaler or pharmacy.
  • Requiring a covered person to pay more than the PBM reimburses the pharmacy or using personal information to solicit a covered person to use an affiliated pharmacy.

Why it’s important: 

• It treats PBMs like all other health providers and insurance companies. 
• It shines a light on this hidden middleman of our healthcare system. 

HB 1979 Reducing the cost of inhalers and epinephrine autoinjectors.

Sponsors: Paul, Leavitt, Duerr, Reed, Ormsby, Callan, Kloba, Doglio, Fosse, Ortiz-Self, Hackney, Shavers

What this bill does:

• Caps the price of a 30-day supply of asthma inhalers & a two-pack of epinephrine autoinjectors at $35.
• If the IRS removes asthma inhalers from the list of preventive care services, the insurance company must establish a minimum cost sharing level for tax-exempt contributions from the enrollee's HSA. 
• If the IRS adds epinephrine autoinjectors to the list of preventive care services, coverage must be provided without being subject to a deductible. 

Why it’s Important:

• It’s a life-saving drug needed on a regular basis, whether enrolled in an insurance plan or not and affected persons may run out of their supply sooner than expected.

STAY TUNED:  

Some of our priorities did not pass.  Look for them to be reintroduced in the 2025 Legislative Session:

• SJM 8006 - Requesting the federal government to create a universal health care program
• SB 5241 - Regulating the consolidation of hospital systems
• HB 1310 - Authorizing physician assistant collaborative practice