Washington’s 2020 legislative session wraps up just as the extent of the coronavirus crisis is becoming clear and further illuminating holes in our health care system. We knew at the start of session that passing bills with much of a price tag would be an uphill battle, but we did see some movement forward on important legislation. Here’s an overview of our wins and losses – and a look ahead at opportunities to advance health equity in our state.

Health equity progress highlights

Coronavirus Response (HB 2965) – When Western Washington became ground zero for the novel coronavirus (which causes COVID-19) outbreak in the United States, legislators acted quickly to provide $200 million to slow the outbreak by funding medical supplies, isolation facilities, and lab testing. Insurance Commissioner Mike Kreidler ordered insurance companies to waive deductibles and co-payments for coronavirus tests, and Governor Inslee announced that the state will cover tests for all uninsured people.

Postpartum Coverage (SB 6128) – Washington legislators have extended Apple Care to a full year after giving birth, contingent on a federal match. This is a key measure that will protect the health of moms and babies and safeguard family economic security – if Congress also acts. We are closely monitoring federal legislation and will send action alerts when community action is needed.

Prescription Drug Affordability (SB 6088, HB 2662, SB 6087) – A trio of bills passed that will help address sky high prescription drug costs and ensure better access to life-saving medications. SB 6088 establishes a prescription drug affordability board responsible for reviewing prices to see if maximum price caps are needed. HB 2662 caps the cost of a 30-day insulin supply at $100 per month and creates a centralized purchasing process for insulin that mirrors the system used by the state to purchase childhood vaccines. SB 6087 similarly caps the out-of-pocket cost to patients for insulin at $100 per month.

Office of Equity (HB 1783) – This bill creates a state Office of Equity that will help reduce disparities and improve outcomes including in health by assisting agencies to apply an equity lens to all decision-making, policies and practices.

Bills that failed to pass

Health care affordability – EOI and partner organizations pushed for sustainable funding to make health coverage more universal and affordable. Ultimately, these bills failed to pass, leaving too many uninsured and underinsured in our state continuing to struggle to access health care.

HB 2821 was a time-sensitive bill that would have replaced a recently repealed federal tax on health insurance companies and used the funding to expand low-income health care programs.

HB 2679/SB 6451 proposed assessing a 3 percent fee on the “excess surplus” of non-profit health insurance companies to fund crucial public health infrastructure and subsidies for people ineligible for federal health care subsidies. Three health insurance companies in Washington are sitting on $4.4 billion in unrestricted surplus from unspent patient premiums.

HB 2901 would have assessed a 1 percent fee on all health insurance claims paid and used the revenue for health care premium assistance for people enrolled in Qualified Health Plans on the Health Benefit Exchange with incomes up to 500% of the Federal Poverty Level.

Apple Health to age 26 (HB 1697) was aimed at expanding insurance coverage to undocumented young adults, who often lack access to life-saving medical care. While many legislators supported this approach, cost was a barrier. More expansive changes under consideration for 2021 may incorporate this population.

Healthy system transparency (HB 2036) would have improved transparency of hospital and ambulatory surgical center finances. Key provisions included standardizing reporting of “facility fee” charges patients often see on hospital bills, and requiring disclosure if hospitals are making money via debt collection agencies.

Looking ahead

The groundbreaking Cascade Care policy passed by the Washington State Legislature in 2019 creates a national model for affordable, quality health coverage options, including standardized plans, a public option with price controls, and extensive subsidies for low- and middle-income residents. These elements are now under development. To fully realize Cascade Care’s promise, however, Washington will need reliable, sustainable new funding sources. The rapidly evolving coronavirus crisis, threat of a possibly deep recession, and major national and state elections all add uncertainty to the policy landscape. But we know that health care access and affordability will be front and center in the public debates.