(St@teside Published May 15, 2007)

Washington:  

During the 2007 legislative session, the Washington legislature passed a number of bills that expand coverage and reform the health care delivery system. Governor Christine Gregoire (D) has signed all of these bills.

Senate Bill 5093: This legislation's express purpose is to provide access to coverage for all children in the state by 2010. Starting July 2007, it funds intensive education, outreach, and administrative simplification efforts to enroll all currently eligible children, covering over one-half of Washington 's uninsured children. Beginning in January 2009, the legislation authorizes the state to expand the State Children's Health Insurance Program (SCHIP) to children who have family incomes up to 300 percent FPL; the current eligibility level is 250 percent FPL. The department is authorized to seek federal financial participation for the expansion population. In addition, children in families with incomes above 300 percent FPL will have access to SCHIP at full-cost. Premiums would apply to children above 200 percent FPL. The legislation also includes a premium assistance program, if cost-effective, for those families with access to employer-sponsored insurance.

House Bill 1569: This legislation authorizes the creation of a Massachusetts-style Connector called the Washington Health Insurance Partnership (WHP). WHP is initially targeting small employers with low-income workers. For a small employer to designate WHP as its health benefits administrator, the employer has to have at least one eligible employee (a Washington resident earning less than 200 percent FPL) and set up a cafeteria plan as defined by Section 125 of the federal income tax code. Cafeteria plans allow pre-tax premium payments by both an employer and an employee. If a small employer meets these two conditions, all of its employees regardless of income can purchase through WHP (even after leaving employment).

In addition, the legislation establishes sliding scale premium subsidies for individuals who earn less than 200 percent FPL based on gross family income on a similar schedule as that currently used by the Washington Basic Health Plan.

Finally, the Washington Health Insurance Partnership board shall submit a study and make recommendations regarding the addition of markets (e.g., individual market and public programs) into the WHP.

Senate Bill 5930: In January 2007, the Washington Blue Ribbon Commission on Health Care Costs and Access submitted a final report that outlined a five-year plan for substantially improving access to quality health care. The final report outlined 16 recommendations and a vision for a high performance health system in the State of Washington. Senate Bill 5930 incorporates many recommendations of the Blue Ribbon Commission including: provisions for chronic care and management, establishment of a quality forum to promote evidence based practices, improved transparency of cost and quality information for consumers, reducing unnecessary emergency room utilization, and additional provisions to make health care affordable and accessible, e.g. expansion of coverage to dependent children under age 25, design of a health opportunity account demonstration for Medicaid, and the possibility of publicly-funded reinsurance.