SENATE BILL REPORT

SB 5822

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background: Under the federal Patient Protection and Affordable Care Act (ACA), all U.S. citizens and legal residents are required to have health insurance coverage or pay a tax penalty. The ACA gave states the option to expand their Medicaid programs to cover individuals up to 133 percent of the federal poverty level, which Washington State has done. The law also establishes state-based insurance exchanges in which individuals and small businesses may compare and purchase health insurance. As a result, Washington State established the Health Benefit Exchange (Exchange) as a public-private partnership to provide a platform for accessing the individual insurance market and the state Apple Health program. Premium assistance and cost-sharing subsidies are also available in the Exchange on a sliding scale for persons between 134 and 400 percent of the federal poverty level.

The ACA allows states to apply for Medicaid waivers and for insurance rules enacted by the ACA, to develop innovative ways to deliver coverage.

Summary of Bill: The Health Care Authority must convene a work group on establishing a universal health care system in Washington. The work group must consist of stakeholders, including:

consumers;
large and small businesses with experience with large and small group insurance and self-insured models;
labor;
health care providers and facilities;
health carriers;
state agencies; and
legislators.

The work group must study and make recommendations to the Legislature on a universal health care system, that is publicly funded and privately delivered, including:

options for increasing coverage and access for uninsured and underinsured;
transparency measures;
innovations promoting quality;
options for ensuring a just transition for all stakeholders;
options to expand health care purchasing in collaboration with neighboring states; and
options for revenue and financing mechanisms to fund the system.

The work group must report its recommendations to the Legislature by November 15, 2020.

Staff Summary of Public Testimony: PRO: The government can play an important role in ensuring people are protected against whatever health care issues arise. People are currently struggling to pay for their health care, and many are drowning in medical debt or becoming sicker because they are unable to access health care. The current system is not meeting the needs of all Washingtonians as a half a million do not have health insurance, and many people are interested in a different approach. A public option is something that has been discussed at the federal level for many years. It would expand medical coverage for everyone and provide protection against out of control health care costs. There is the possibility that the federal government will work with states to implement universal health care in the near future, and it is important Washington is ready to implement once this option becomes available. This bill would help Washington create an actionable plan for pursuing universal health care. A universal health care system would address existing gaps in coverage and equity issues in health care. There are a number of health disparities related to people of color and low-income people because they are unable to afford health care in the current system. The bill should be amended to broaden the membership of the work group, and change the work group's goal so it is publicly funded and administered, and a privately delivered system. The work group is not necessary since plans have already been developed and models from other countries can be used.

OTHER: The work group's deadline should change since it comes after the 2020 elections and health carriers should not be included in the work group. The Legislature should consider SB 5222 instead of this bill.

Persons Testifying: PRO: Senator Emily Randall, Prime Sponsor; Chris Covert-Bowlds, Health Care for All Washington; Gary Renville, Project Access Northwest; Reena Koshy, Washington Coalition to Protect our Patients; David Loud, Health Care Is a Human Right Campaign; Marcia Stedman, Health Care for All Washington; Cindi Laws, Health Care for All Washington; Jonathan Seib, Molina Healthcare of Washington; Nathan Rodke, Washington CAN; Kathryn Lewandowsky, Whole Washington; Bailey Boyd, citizen; Sadiqa Sakin, President, NAACP Seattle/King County; Nikki Gomez, citizen; Nicole Macri, Washington State Representative. OTHER: Tobias Graves, citizen.