View the Work Group Meeting:
- Watch the full meeting, which includes one breakout session
- Watch breakout session 2
- Watch breakout session 3
This fourth meeting of the Work Group discussed three general healthcare models that will be analyzed and dynamically modeled by the actuaries so that variations can be considered by Work Group members at their next meeting on August 25th.
- Universal coverage administered by the state – State government sets the benefits package, contracts directly with all providers, and pays for all care – this is the publicly funded model that HCFA-WA supports.
- Universal Coverage administered by Multiple Private Plans - State government develops the policy and benefits package, but delegates most financial risk, payer-related functions, and delivery system management to private insurers.
- “Fill in the Gaps” Coverage for people without affordable access – This approach builds on the Cascade Care model, and would create one or more “standard” options that would be offered on our state’s ACA Exchange, with subsidies based on income level.
Models A and B would require Federal cooperation for residents who have coverage under Federal programs such as Medicare, Medicaid, Federal retiree programs, etc. All three models were discussed by each of the 3 smaller breakout groups.
There was general agreement that the desired plan would cover everyone, including immigrants and undocumented state residents especially given the current coronavirus pandemic, and that a universal system would require government control of benefits and prices.
The status-quo “fill in the gaps” model was generally viewed unfavorably, although it was also seen as potentially the most politically feasible at this time, given the state’s pandemic-caused $9 billion budget shortfall. There was general agreement that if this “incremental” model were the recommended one, it would be desirable to include a “next steps” scenario explicitly stating the intention to move toward universal coverage in the future, whether that be administered by the state (Model A) or by private coverage plans (Model B).
Topics addressed in the breakout groups included: whether participation would be mandatory; the level of benefits; how to pay for it; the level of cost-sharing; the problem of healthcare costs and how to counteract unnecessary variations in the price of procedures; would there still be a market for supplemental insurance; how to incentivize “high-value”, i.e., primary, care; the importance of going beyond traditional medical care and addressing the social determinants of health; the necessity for a “just transition” for those losing their jobs due to implementation of a new system of health coverage; how to deal with large multi-state businesses with self-administered health care plans (ERISA waivers); and the importance of including a multi-state solution, as specified in the budget proviso that funded this Work Group.
Public Comments included those from HCFA-WA members Cris Currie and David Loud, and other universal health care advocates. They were overwhelmingly in favor of the state-administered universal option. The importance of addressing racial equity and hearing personal stories from state residents was also emphasized.
Do you have a personal story you would like to share at the next Work Group meeting on August 25th?
It is especially valuable for the Work Group to hear from a variety of diverse populations about their experiences in accessing health care.
Thank you for taking action!