Health Care
Affordable and accessible health care is essential to economic justice.
Health care is unaffordable. We’re in the fight to change that.
High and unpredictable health care costs are harming our communities. For many years, the cost of care has outpaced inflation, what families can afford, and what Washington state can sustainably fund. Too many people are forced to skip necessary treatment, live without insurance, or rack up debt because they can’t afford the care they need — and it’s only getting worse.
The only path to a sustainable, affordable system that guarantees care for all is to transition to a universal health care model. As we work toward that milestone, lawmakers must also invest in critical health care safety net programs and subsidies, control costs, and expand corporate accountability protections.
Policy solutions that center affordable, accessible care
Our goal is to ensure no one has to sacrifice their financial stability to get needed care. We advocate for policies that relieve health cost burdens through up- and downstream interventions.
Provide immediate affordability and access for people struggling most
Washington’s health care safety net must be available to anyone who can’t afford to get care right now. This means providing immediate financial relief by subsidizing the cost of care via low-cost public insurance plans and premium affordability assistance, eliminating medical debt, and expanding care for immigrants shut out of our current system.
Regulate prices across the health care system
Setting limits on what health care entities can charge for medical services and prescription drugs is a proven approach to lowering the cost of care for patients, employers, and the state. Price controls can be applied to smaller components of the health care industry and eventually be scaled up to a universal single-payer model of care.
Slow down industry consolidation and promote corporate accountability
We can address the growing power of health industry monopolies by increasing oversight of health care consolidation and vertical integration. Giving state agencies greater authority to regulate mergers and acquisitions within the health care ecosystem would allow our state to better protect patients and workers from rising prices and poor health outcomes, while also increasing public transparency.
How we’re moving toward that future
Every year, during Washington state’s legislative session, we advocate for evidence-based policy solutions that help bring our vision for a more equitable future closer to reality. These practical policy ideas are communicated to lawmakers and everyday Washingtonians as viable solutions to some of our toughest problems.
EOI has helped lead the way on improving health care access and affordability for Washingtonians.
From expanding the Basic Health Plan to targeting subsidies and tackling the increasing corporatization of health care, we are working towards a health care system that prioritizes affordable, high-quality care for all.
Cascade Care
With the passage of Cascade Care in 2019 and Cascade Care 2.0 in 2021, we fought for and won alternatives to health plans with high out-of-pocket costs and limited coverage.
Cascade Care includes a standard insurance plan and a public option called Cascade Select that increases access to high-value care at a lower cost, and a subsidy program called Cascade Care Savings that, together with federal premium assistance, helps bring monthly premiums down to low or no cost for many around the state. Over 100,000 Washingtonians benefit from Cascade Care Savings and pay less for insurance thanks to state-funded premium assistance.
Reference-Based Pricing
We worked with partners to pass landmark legislation in 2025 to improve access and drive down health care costs for public and school employees.
This model uses a cost-control approach known as reference-based pricing to rebalance health care spending. This puts an upper limit on what hospitals can charge for inpatient and outpatient medical services as well as a minimum reimbursement level for critical and underfunded services like behavioral health and primary care. These new price limits reduce costs for patients while also ensuring that essential preventative care services are well-funded.
We need regulation to make healthcare truly affordable.
Even insured patients can’t access care if they can’t afford it
These days, most people in Washington have health insurance. This is a major achievement made possible by decades of powerful advocacy at the federal and state levels. However, affording care is a challenge for people everywhere. The cost of health care has risen persistently over the last few decades, much faster than earnings or overall economic growth.
Unaffordability is causing people to defer or delay essential care and treatment. In a 2025 survey of nearly 1,400 Washingtonians, 68% of respondents experienced a health care affordability challenge in the prior year, and 66% avoided seeking medical treatment due to cost. For those who received care, 35% sacrificed other necessities like food or rent to pay for their care, and 20% were left with medical debt.
Skyrocketing costs hurt our economy and puts strain on our safety nets
Beyond impacting individual patients, rising health care prices threaten the resilience of our economy by making it more difficult for employers, particularly small businesses, to provide insurance coverage for their employees. And when more people can’t afford care on their own or through their jobs, more and more people have to rely on our state safety net programs, like Apple Health/Medicaid and Cascade Care Savings subsidies on the individual marketplace. These programs are an essential part of our care ecosystem. Yet high costs make it more expensive for Washington state to maintain these core programs, resulting in perennial budget challenges and limits on how many people can be served.
Consolidation leads to higher costs and worse patient outcomes
Health care industry consolidation is a key contributor to rising prices. When health care entities merge with others, they can use their increased market power to set prices to maximize their own revenue and profit, regardless of the actual cost of care.
The health care industry in Washington, and around the country, has become increasingly consolidated over the last several decades because of limited state and federal regulation of health system transactions. This unregulated environment allows health system companies and private equity companies to consolidate across the sector, and offer worse care at higher prices to increase their profits.
Reports & Articles
This report provides a series of data snapshots that illustrate our state’s progress toward embedding the values of fairness, care, and opportunity into the foundations of our economy.
Together, these solutions will help keep our health care system working for those it was created for: the patients.
Initiative Measure 1 will provide a higher minimum wage for more people working in Burien over time.
The truth is, Optum and other mega giants are buying up our health care system – and patients are paying the price. So what can we do about it?
More about our work
Progressive Revenue
Washington’s tax code is upside down. We need a balanced tax system where we all pay our fair share, and public revenue sustainably funds the services our communities and economy rely on to grow.
Dignified Work & Resilient Communities
Good jobs with fair wages, strong benefits, and safe conditions are the bedrock of dignified work, thriving communities, and a stable economy. And no one should have to choose between going to work and caring for themselves or a loved one.
About Our Advocacy
Fighting for bold and grounded policy ideas that make thriving possible for all of us takes collective action. Learn more about how we work in the state capitol and in coalitions to advance our mission.