2022 HCHR Legislative Wrap-Up

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HCHR Members United to Improve Health Care

Submitted by HCHR-WA Policy Co-Chairs Emily Brice (Northwest Health Law Advocates) and Sam Hatzenbeler (Economic Opportunity Institute)

Despite strong industry opposition, HCHR members united to build community power and elevate a number of legislative and budget items to improve health care access and affordability, rein in costs, and protect health care workers. You signed in on bills, testified, sent letters to legislators, and asked key questions – all in service of achieving our goals of advancing universal coverage and improving access to care. We have much to be proud of!

At the outset of the 2022 legislative session, the Health Care is a Human Right campaign established a strong platform to advance legislation towards the following goals:

  1. Make progress towards universal health care in WA State and our nation
  2. Improve health care affordability and access, while driving down escalating industry profits
  3. Advance racial equity and address social determinants of health and disparities
  4. Ensure that no one loses access to care and strengthen existing programs

Some bills on our platform failed to pass. It is particularly notable that several bills aiming to regulate health care industry profit and drive down the cost of health care made initial traction but were ultimately unsuccessful, largely due to enormous opposition from health industry giants. That tells us we need to mobilize and come back even stronger next year!

Here’s a rundown of our successes and advancements this session:

  • Immigrant health care coverage: Washington Legislators took an important step this session to advance equity for immigrants by including over $12 million in the final budget for two new pathways for health care access. Funds are included to create an Apple Health equivalent program for low-income immigrants earning 138% or less of the federal poverty level, as well as funding for agencies to pursue a federal waiver which would allow immigrants at all incomes to purchase plans on our state marketplace, with subsidies for those earning 139-250% FPL. Both programs are expected to begin by January 1, 2024.
  • Medicare Affordability cliff: The final budget includes two initial steps to begin tackling unaffordable out-of-pocket costs for low-income Medicare enrollees. The budget includes over $10M on an ongoing basis to remove the asset test barrier to eligibility for Medicare Savings Programs that assist with costs, as well as $75,000 for DSHS to complete a study on more comprehensive options to improve Medicare affordability for low-income seniors and people with disabilities. 
  • Medigap Nondiscrimination: The final budget includes $200,000 for the Office of the Insurance Commissioner to study the impact of a “guaranteed issue” open enrollment for Medicare Supplemental (Medigap) policies for people who miss their initial enrollment window or want to switch to Medigap after initially selecting Medicare Advantage. The aim of the study is to enhance consumer protections and expand access to Medicare supplemental insurance.
  • Prescription drug affordability board (SB 5532): The Legislature passed SB 5532 with bipartisan support and the bill is now on its way to the Governor’s desk. Starting in June 30, 2023, the new PDAB will have the authority to conduct an annual affordability review of 24 drugs per year that meet certain cost and market criteria. Starting in 2027, the board may establish upper payment limits on up to 12 drugs if they have led to or will lead to excess patient costs. The final bill allows the board to fine drug companies if they fail to provide data and bar manufacturers from participating in the WA market for three years if they withdraw as the result of an upper payment limit. Stronger elements of the original bill language were removed, such as establishing a fine on manufacturers for excessive price increases and allowing more drugs to be reviewed. The final budget includes $1.5m in implementation funding. 
  • Protecting consumers from balance billing (HB 1688): HB 1688 passed with bipartisan support as well as more than $440,000 for implementation funding. The bill aligns state and federal law to bring stronger protections for patients against surprise medical billing, a practice which can cause devastating financial hardships and lifelong medical debt. The bill prohibits providers from asking patients to waive their rights and adds new protected services such as emergency behavioral medicine, air ambulances, and post-stabilization care. 
  • Primary care (SB 5589): This bill sets a health care spending goal of 12% on primary care through our state’s Health Care Cost Transparency Board. By August 1, 2023, the HCCTB will measure and report on primary care expenditures. The bill has been delivered to the Governor and has around $300,000 in implementation funding in the final budget. 
  • Insulin affordability (SB 5546): SB 5546 lowers the existing $100 per month copays for a 30-day supply of insulin to $35. The bill has been signed by Governor Inslee and is effective June 9, 2022. The copay limits are only applicable for patients in private state-regulated plans. The original bill language included a provision for a once-yearly 30-day emergency supply insulin, which was unfortunately removed. Notably, a related bill (HB 1728) not on HCHR’s platform also passed, which extends the deadline for the Total Cost of Insulin Workgroup’s report on strategies to improve insulin affordability and newly requires recommendations for emergency insulin fills.
  • Preventing discrimination in cost sharing (SB 5610): This bill will help prevent discrimination and undue financial hardship for patients who receive coupons or other vouchers to help cover needed prescription drugs. Health plan carriers (private state-regulated plans and PEBB/SEBB) will now be required to count payments towards an enrollee’s cost-sharing or out-of-pocket limits, whether the payment is made by the enrollee or by another source such as through a drug voucher program (with some exceptions such as for drugs with a generic or therapeutic equivalent). The final budget includes $43,000 to the OIC for implementation costs. 

    Some bills on our platform failed to pass. It is particularly notable that several bills aiming to regulate health care industry profit and drive down the cost of health care made initial traction but were ultimately unsuccessful, largely due to enormous opposition from health industry giants. That tells us we need to mobilize and come back even stronger next year!
  • Keep Our Care Act (SB 5688): This bill received a hearing in the Senate Law & Justice Committee, but failed to pass through the legislative process. KOCA would have regulated health care consolidations like mergers and acquisitions between hospitals and health care provider organizations, a key to driving down patient costs, holding big health systems accountable, and maintaining patient access to high quality care.
  • Safe and Healthy bill (HB 1868): This critical bill would have improved working conditions for health care workers who have experienced enormous strain during the pandemic  by protecting them against high patient loads, and by requiring hospitals to follow safe staffing standards, and enforce existing overtime and rest/meal break laws. The bill also would have helped with the health care workforce shortage by investing in workforce development. 
  • Dental therapy (HB 1885):  HB 1885 included recommendations from the Dental Therapy Task Force to create a new state board of dental therapy and hygiene, as well as to develop licensing requirements for a new dental therapist provider category. This bill would have helped advance equity by making oral health care more accessible and affordable, particularly for communities of color and low-income communities which have historically experienced higher barriers for oral care than their white and higher-income counterparts. 
  • Health care contracting bill (HB 1741): House Health Care Committee Chair Eileen Cody championed this bill aimed at preventing anticompetitive practices in contracting between hospitals and insurance companies, which drive up health care prices. The bill, which passed both the House policy and fiscal committees, targeted similar practices as the successful lawsuit against California’s Sutter Health system’s anticompetitive contracting practices.

Looking ahead, our HCHR Policy Committee will take stock of the unique role we can play in supporting policy implementation, partnering with state agencies to advance affordable, universal coverage, and learning together so we can prepare for 2023 and beyond!


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