E2SSB 5399: Creating a universal health care commission

E2SSB 5399 Concerning the creation of a universal health care commission.
House Amended Bill text | House Bill Report

Sponsors: Senators Randall, Cleveland, Das, Dhingra, Frockt, Hunt, Kuderer, Liias, Lovelett, Nguyen, Nobles, Robinson, Saldaña, Stanford, Van De Wege, Wellman and Wilson, C..

What this bill does: Senate Bill Version: Declares the Legislature’s intent for all state residents to have publicly financed and privately and publicly delivered health care coverage that is comprehensive, equitable, and affordable,   that the plan be presented to the Legislature by Nov. 1, 2024, and implemented by 2026. See House-amended bill update below.

Why it’s important:  Builds on the actuarial work done for the UHC Work Group and begins the implementation of the plan favored by a majority of the Work Group: a unified plan for universal health coverage run through a state agency.

HCFA-WA’s position:  ENDORSED Senate Version. Support House Version, offering our amendments.
Read our 2SSB 5399 Q&A

Progress: Passed the House Health Care and Wellness committee March 24 with striking amendment.* 

March 18 Hearing Notes:
Dr. Sherry Weinberg, policy chair of HCFA-WA, submitted two proposed amendments to the bill, to move the timeline one year earlier, to 2023 for completion of the plan and 2025 to implement. We also requested that the bill specify who would chair the commission, ideally an health systems expert outside of government or health industry. We’re hoping to see a patient advocate representing individuals with chronic health conditions added to the commission and will propose an amendment if necessary. HCFA-WA policy team members testified in support before the amendment was introduced. Check out their testimony here: Dr. Sherry Weinberg, Marcia Stedman, Elaine Cox

March 24 Amended Bill:
Rep. Eileen Cody submitted a striking amendment* which replaces most of the bill, significantly changing the Commission’s structure, timeline, and functions. The essence of this amendment is the recognition that any state-based universal health care program is going to depend on funding and authorization from the federal government, which we do not currently have. The intent of the amendment appears to be to shift the focus of the Commission on immediate concerns: “implementable changes to increase health care access, reduce health care costs, reduce health disparities, improve quality, and preparing for a transition to a unified health care financing system”.

We're very pleased that our requested amendments were incorporated:

  • removing 4 of the original 8 legislators on the Commission
  • adding a chair to the Commission
  • providing an earlier deadline for the initial report

The amendment would make the Commission permanent, rather than time-limited, thus negating a deadline for both a plan and implementation of universal coverage. It would remove 9 positions from the Commission (which would somewhat reduce the budgetary requirement). It makes the representative from the Health Care Authority the chair. It also removes expansion of Medicaid to immigrants.

HCFA WA is dismayed to see the timeline removed, but we note that the amendment does require a baseline report for 2022 with ongoing annual reports containing the same topics as the original bill, and adds further elements to develop and prepare for a universal healthcare system.

It remains to be seen if the House will further amend this bill and what will happen through the Senate reconciliation process should it get passed in the House.  See Bill Report on Senate Version here

*Striker / striker amendment / striking amendment: Amendment removing everything after the title and inserting a whole new bill. Very similar to a substitute, but because substitutes are not allowed on a chamber floor or in the Second House, strikers are used instead.

Check out this great primer on the state legislative process and definitions of terms.

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