Prescription For Relief — Legislative Solutions For Washington’s Health

News by Blanchard Alice

OLYMPIA, WA — There are bills in committee this legislative session that aim to address some of the impacts of HR 1, known as the "One Big Beautiful Bill Act", at the Washington state level.  Unfortunately, for those who are concerned about losing healthcare, due to the expiration of the premium tax credits at the end of 2025, the next few years will be uncertain. 

Often decisions are made by "the people in the room", which is why it's important to know what bills they are discussing, and how your opinion can be heard. 

What's happening in Olympia?

Currently, the Washington Health Trust, the state's plan for universal healthcare for all Washingtonians, is stuck in the legislature. While non-profits like Whole Washington and activists work on building political will, several other healthcare bills in this year's legislative session show that Washingtonians don't plan on waiting around for the federal government to create solutions.

SB 5955 

Created by a partnership between Whole WA, the authors of the WA Health Trust, and the staff at Senator Bob Hasegawa's office, is a bill aimed at de-privatizing Medicaid. Currently, the state administers both dental and vision for Medicaid, but private insurance companies like Melina or United Healthcare, called managed care organizations (MCOs), administer the majority of other healthcare services. 

In September of last year, a report published by the Physicians for a National Health Program noted that "when a state de-privatizes its Medicaid program . . . total state overhead can drop to about 4 to 6 percent or less." 

5955 lays out a timeline of less than a year to cancel contracts with these large insurance companies for Medicaid plans and replace them with a fee-for-service model managed by the state. Models like these reduce the administrative overhead associated with MCOs by about 13%, which would be reinvested to allow Washington to cover more people under Medicaid.

SB 5948 

This bill establishes timelines for the Universal Health Care Commission in Washington. 

The goal is to codify deadlines for deliverables to promote efficiency and accountability. Currently, the commission doesn't have mandates to accomplish set goals on a timeline, and without that structure, progress since the commission began operating in 2021 has been slow. 

Oregon's version of a healthcare commission includes codified timelines and has been making progress toward universal healthcare more quickly than Washington. SB 5948 aims to follow the more efficient example Oregon is setting. 

SB 5948 notably costs nothing in the first year, where all that is required from the commission is clear recommendations on key design components. Year two would focus on the creation of three committees: citizen, provider, and finance, which is laid out in more detail in the language of the WA Health Trust. In 2029, the UHC Commission would then be required to present universal healthcare legislation to the legislature.

Public Hearings

On Jan 22, HB 2100 had a public hearing with the House Finance Committee. The bill would authorize a new payroll expense tax on high-earning jobs, paid by large operating companies in Washington beginning July 1, 2026. 

Representative Shaun Scott testified during the public hearing, noting that "The Office of Financial Management has detailed how HR1 will ransack Medicaid". Looking forward to solutions, Scott described the details of "a modest payroll tax that the largest 1% of corporations in our state will pay to support programs put under fire by the Trump administration."

This revenue would be split, with 51% dedicated to the Well Washington Fund, which the bill creates, and the remainder being deposited into the state's general fund. The bill dictates that the Well Washington Fund only be used for higher education programs, healthcare, cash assistance programs, and energy and housing programs.

Scott insists that this bill creates safety nets for the most vulnerable without damaging the corporations who would fund it: "Some of the largest companies in our state received massive tax breaks from HR 1 to the tune of billions of dollars . . . and these are companies that are also going to be able to deduct payroll tax expenses from their federal tax returns." The impact after accounting for this would be "pretty marginal," Scott estimated, "House Bill 2100 will stabilize state investments in programs we all depend on."

Lianna Kressin, of the Statewide Poverty Action Network, also spoke in strong support of HB 2100 as a way to mitigate the "fear and uncertainty" she witnessed firsthand during listening sessions the network conducted across the state last year. "These cuts frame poverty as an individual failure instead of a systematic one, forcing families to go without and states to do more with less," she said about the aftermath of HR 1, "Over the next five years . . . our state will have to shoulder a massive additional financial burden to maintain the same level of services."

SB 5946 

A short and simple bill that expands who can qualify for the Medicaid program by including workers who earn up to 300% of the poverty level. It focuses on helping a particularly hard-hit population of Washingtonians who earn too much to qualify for the program, but not enough to afford insurance at its current cost.  

SJR 8206 

This bill seeks to add a constitutional amendment that would make it a state obligation to provide every resident access to "cost-effective, clinically appropriate and affordable health care as a fundamental right" regardless of age, financial means, citizenship status, race, gender or sex.

SB 5947 

A bill that simply establishes the Washington Health Care Board, which will be necessary to design and implement a universal healthcare plan for WA residents if the State-Based Universal Health Care Act, known as SBUHCA, is passed federally. Organizations, such as Health Care is a Human Right, feel SBUHCA is a priority and have been working for several years to streamline the implementation of universal healthcare once the path for the state has been cleared. 

Other bills currently in the legislature that focus on healthcare include HB 2564, which allows the Health Benefit Exchange to improve affordability and access, and HB 2250, which opposes language in charity care that reduces accessibility for immigrants and non-residents by imposing significant application barriers. 

HB 2564 had a hearing on January 28 with the House Health Care and Wellness Committee. On January 29 the Senate Health and Long-Term Care Committee heard bills SB 5946 and SJR 8206, with testimony in strong support from Thomas Kennedy of Whole Washington.