By Sam Hatzenbeler, Economic Opportunity Institute and HCHR Policy Committee Co-Chair
The 2021 legislative session is proof of what can happen when we roll up our sleeves and work together to pursue health care for all. The beginning of the 2021 legislative session was daunting. As we faced a bleak initial budget outlook and transitioned to a virtual session, we questioned whether we should rein in our hopes for any significant progress on health care reforms this year. But the devastation caused by COVID and the economic recession, on top of existing disparities, underscored the need to invest in an equitable health care system that can serve all Washington residents.
The 2021 policy agenda our HCHR members adopted guided us to:
- Make progress towards universal health care in WA State and our nation Improve affordability of health care
- Advance health and racial equity to reduce disparities
- Protect what we have at a time when many Washington residents are in crisis
Did we make progress? Yes we did! From advancing universal health care, to improving insurance affordability and access to Medicaid, to laying a foundation for immigrant access to care, and prioritizing behavioral health expansion and drug affordability, 2021 was an incredible year. And to top it all off, we won an historic progressive tax reform: a tax on capital gains!
Highlights of key victories from our legislative agenda
Universal Health Care Commission (SB 5399): Building off of the work of the Universal Health Care Workgroup in 2020, this bill creates a permanent Commission to prepare for the development and financing of a universal health care system in Washington State. The Commission will include legislative and agency leads, as well as consumer and tribal advocates. The appointment process is already underway and Commission meetings will begin this summer – stay tuned for more!
Cascade Care “2.0” (SB 5377): Following the creation of the public option in 2019, this bill and budget allocation provides $50 million in health care premium subsidies to people with incomes under 250% of the federal poverty level who buy health coverage on the Health Benefit Exchange starting in 2023. An additional $30 million was set aside to rapidly provide premium-free subsidies to low-income child care workers in a pilot, as early as this coming November.
Capital gains (SB 5096): Without tax reform, our state’s critical health, social, and transportation services will continue to be hobbled, and funded on the backs of lower income residents. This bill creates a 7% tax on capital gains on investments and stocks over $250,000. The revenue will be directed towards early learning and education, freeing up other resources for priorities like health care and a Working Families Tax Credit.
Postpartum Apple Health expansion (SB 5068): This crucial bill will help address racial and gender disparities in our state by extending Pregnancy Medicaid coverage from two months to one year postpartum for WA residents up to 198% of FPL, regardless of immigration status. Postpartum coverage will be available to birthing parents who receive Medicaid during their pregnancy, and also allows eligible individuals to enroll for up to one year postpartum even if they didn’t receive Medicaid during their pregnancy, which ensures coverage for those who may have lost their jobs or health care through a spouse after pregnancy.
State Office of Behavioral Health Consumer Advocacy (HB 1086): The new Office will be charged with establishing rules, standards, and procedures for behavioral health consumer advocacy services across the state. The Officewill contract with a private nonprofit organization to serve in an “ombuds” role, providing behavioral health consumer advocacy services (such as resolving consumer complaints) by July 1, 2022.
988 crisis hotline system (HB 1477): This bill addresses our growing need for equitable access to behavioral health care by establishing a state 988 crisis hotline for suicide prevention and mental health crisis. In addition to the hotline, the bill makes other reforms aimed at ensuring Washington residents have access to “next-day” urgent behavioral health care at times of crisis. (Note: not yet signed by the Governor)
Generic prescription drugs and insulin (SB 5203): Addresses out-of-control drug prescription prices by authorizing the state to enter into partnerships to produce, distribute, and purchase generic prescription drugs and insulin, if doing so would result in cost-savings for the state or Washington residents.
Health Systems Transparency (HB 1272): Improves hospital financial transparency by requiring hospitals to provide detailed information about their expenses and revenue in reports to the Department of Health, additional details in demographic data and charity care reporting, and additional details about their community health improvement activities in the federally-required community-based needs assessments.
Immigrant Health Care: While a bill aimed at establishing equity in health care for immigrants (HB 1191) did not pass this session, we supported an immigrant-led coalition of advocates in winning $35M in budget funds for direct care at clinics for underinsured and uninsured Washington residents, regardless of immigration status, as well as a budget proviso directing the Health Benefit Exchange to set up a long-term coverage program for immigrants by 2024.
Access to dental care: While the dental therapy bill did not pass, our coalition supported a successful budget proviso to convene a task force to examine how to expand the current practice of dental therapy on tribal lands to a statewide scale.
Advocates have much to celebrate as we take stock of these past months. Looking ahead to the legislative interim and the next session, we have the opportunity to set the table for strategically advancing systemic change through universal coverage, access to affordable coverage, and addressing health and racial disparities in our state.
Thank you all for your hard work and dedication to leading the charge for health care reform in our state and beyond! Your calls, emails, and support made the difference this session!
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