The Universal Health Care Work Group Budget Proviso


The budget proviso contains the directions for the formation of, and the work of, the Universal Health Care Work Group. The budget proviso, which is like a line item in a budget, was passed in the House Budget HB 1109, Section 211, on pages 135 & 136 at the end of the 2019 Legislative Session:

(57) The health care authority is directed to convene a work group on establishing a universal health care system in Washington. $500,000 of the general fund—state appropriation for fiscal year 2020 is provided solely for the health care authority to contract with one or more consultants to perform any actuarial and financial analyses necessary to develop options under (b)(vi) of this subsection.

(a) 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:

(i) Consumers, patients, and the general public;
(ii) Patient advocates and community health advocates;
(iii) Large and small businesses with experience with large and small group insurance and self-insured models;
(iv) Labor, including experience with Taft-Hartley coverage;
(v) Health care providers that are self-employed and health care providers that are otherwise employed;
(vi) Health care facilities such as hospitals and clinics;
(vii) Health insurance carriers;
(viii) The Washington health benefit exchange and 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
(ix) Legislators from each caucus of the house of representatives and senate.

(b) The work group must study and make recommendations to the legislature on how to create, implement, maintain, and fund a universal health care system that may include publicly funded, publicly administered, and publicly and privately delivered health care that is sustainable and affordable to all Washington residents including, but not limited to:

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

(ii) 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;

(iii) 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;

(iv) Options for ensuring a just transition to a universal healthcare system for all stakeholders including, but not limited to, consumers, businesses, health care providers and facilities, hospitals, health carriers, state agencies, and entities representing both management and labor for these stakeholders;

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

(vi) Options for revenue and financing mechanisms to fund the universal health care system. The work group shall contract with one or more consultants to perform any actuarial and financial analyses necessary to develop options under this subsection.

(c) The work group must report its findings and recommendations to the appropriate committees of the legislature by November 15, 2020. Preliminary reports with findings and preliminary recommendations shall be made public and open for public comment by November 15, 2019, and May 15, 2020.

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