ByRepresentatives Macri, Frame, Dolan, Riccelli, Ryu, Thai, Stanford, Robinson, Tharinger, Jinkins, Tarleton, Ormsby, Davis, Stonier, Appleton, Chapman, Valdez, Bergquist, Pollet, Santos, Doglio, and Lekanoff

AN ACT Relating to providing a pathway to establish a universal health care system for the residents of Washington state; creating new sections; and providing an expiration date.

(a) Health care is a human right and it is in the public interest that all residents have access to health care that improves health outcomes, contains health care costs for the state and its residents, and reduces health disparities;

(b) The legislature intends to control health care costs so that Washington is able to achieve a sustainable health care system with more equitable access to quality health care;

(c) H.R. 6097, the state-based universal health care act of 2018 was proposed to establish a flexible framework under which states could provide comprehensive universal health coverage to all of their residents;

(d) It is prudent for the state to explore mechanisms to operate and fund such a program if H.R. 6097 or similar federal legislation is enacted; and

(e) Despite the progress Washington has made since the enactment of the patient protection and affordable care act, not all state residents can access or afford health coverage in the current market. As of 2017, four hundred thousand Washington residents remained uninsured, and a growing number go without care because of growing health care costs.

(2) The legislature therefore declares its intent to provide a policy and financial framework for how the state could achieve universal coverage and equitable access and outcomes for all residents in the future, while concurrently evaluating efforts to ensure statewide affordable access and improvements to coverage for all residents in the preceding years through a public option and standardizing benefit plan designs.

(3) This section does not create any new entitlement to services or cause of action under this act, and cannot form the basis for a private right of action.

NEW SECTION. Sec. 2. (1) The health care authority shall convene a work group on establishing a universal health care system in Washington. The work group must consist of a broad range of stakeholders with expertise in the health care financing and delivery system, including but not limited to:

(b) Large and small businesses with experience with large and small group insurance and self-insured models;

(f) State agencies, including the office of financial management, the office of the insurance commissioner, the department of revenue, and the office of the state treasurer; and

(2) The work group must study and make recommendations to the legislature on a universal health care system that includes publicly funded, privately delivered health care that is sustainable and affordable to all Washington residents including, but not limited to:

(a) Options for increasing coverage and access for uninsured and underinsured populations;

(b) Transparency measures across major health system actors, including carriers, hospitals, and other health care facilities, pharmaceutical companies, and provider groups that promote understanding and analyses to best manage and lower costs;

(c) Innovations that will promote quality, evidence-based practices leading to sustainability and affordability in a universal health care system. When studying innovations under this subsection, the work group must develop recommendations on issues related to covered benefits and quality assurance and consider expanding and supplementing the work of the Robert Bree collaborative and the health technology assessment program;

(d) Options for ensuring a just transition to a universal health care system for all stakeholders including, but not limited to, consumers, businesses, health care providers and facilities, hospitals, health carriers, and state agencies;

(e) Options to expand or establish health care purchasing in collaboration with neighboring states; and

(f) Options for revenue and financing mechanisms to fund the universal health care system. If funds are appropriated specifically for this purpose, the work group may contract with a consultant to perform any actuarial analysis necessary to develop options under this subsection (2)(f).

(3) The work group must report its findings and recommendations to the appropriate committees of the legislature by November 15, 2020.