Access to health care is imperative to the health of our communities and economy. However, many people face significant barriers in accessing affordable, high-quality health care that meets their cultural needs. A profit-driven medical system, systemic racism, and economic and geographic disparities leave many without adequate health care. The COVID-19 pandemic further intensified disparities.

Washington State has made significant advances in health care access, yet big gaps still remain. Just this past legislative session, Washington State expanded postpartum Medicaid coverage for low-income mothers and birthing parents, established a state-based premium subsidy in the Health Benefit Exchange, dedicated $30 million for a premium-free health insurance subsidy program for eligible child care workers, and began exploring options to allow undocumented immigrants to access health insurance.

These are important steps forward, but we need new federal policy solutions and investments to rein in skyrocketing health industry costs and make access to health care a right available to all.

Congress is now considering a $3.5 trillion 10-year budget package. Committees in both the House and Senate have until September 15^th to decide on the details and finalize the budget. We urge Congress to pass a final budget reconcialtion package that includes the following provisions:

• Expand Medicare to include dental, vision, and hearing. Dental, vision, and hearing services are essential to well-rounded health care, but seniors on Medicare must purchase extra separate insurance to have these services covered. In 2018, of all Medicare beneficiaries, 75 percent of those who needed a hearing aid, 70 percent of those who needed dental care, and 43 percent those who needed an eye exam were not able to visit a specialist. By extending Medicare to provide these benefits, nearly 38 million traditional Medicare enrollees would be newly eligible for dental, vision, and hearing coverage, including nearly a million people in Washington State.
• Invest in home and community-based services. Nearly a million people are currently on wait lists for home and community-based services. Investing in these crucial services would allow seniors and people with disabilities to remain at home and in their communities, rather than needing to be transferred to much more expensive nursing homes, which have seen dangerously high rates of COVID infections.
• Allow the federal government to negotiate drug prices. Prescription drugs have become unaffordable for many, with life-saving medications, such as insulin, increasing as much as 70 percent in price in a few years. Prescription drug prices in the U.S. average over two times those seen in other wealthy countries. Allowing drug prices to be negotiated on behalf of Medicare and private plan beneficiaries could save up to $530 billion over the next 10 years and has strong bi-partisan and public support.
• Close the Medicaid coverage gap in the 12 states that have refused to expand Medicaid. The Affordable Care Act, or Obamacare, encouraged states to expand Medicaid to cover most lower income adults, with the federal government picking up most of the tab. But some states opted not to expand Medicaid for partisan political reasons, mostly Southern and Midwestern states with large BIPOC populations. Because of this, the burden of the coverage gap falls disproportionately on people of color. Uninsured Black adults are more than twice as likely as White and Hispanic uninsured adults to fall in the coverage gap. People in the coverage gap have limited family income and are unlikely to be able to afford to buy coverage, as they are not eligible for premium subsidies. Developing a federally-administered program could provide coverage for over two million low-income people across the country who currently lack coverage.
• Make the American Rescue Plan (ARPA) subsidies permanent. The ARPA expanded health insurance subsidies for people with incomes above the Medicaid limits, who still need help covering insurance premiums. But those subsidies are set to expire. Making them permanent would provide support and access to health care for over a million previously uninsured Washingtonians.
• Target maternal health disparities by including key elements of the Black Maternal Health Momnibus Act. Nationwide, Black mothers are 3 to 4 times more likely to die due to pregnancy-related causes than their white counterparts. Key policy solutions like requiring a permanent postpartum Medicaid extension to one year in every state and investing in community-based partners will save lives and help reverse the deep inequities caused by institutionalized racism.

The pandemic showed us how important access to health care is to community and economic well-being. Advancing these policies at the federal level will help bolster existing programs in Washington State, and, more importantly, help us emerge from the pandemic a healthier and more equitable nation.