These bills will establish a healthcare trust that will cover every resident in Washington state. Residency is explicitly defined and those who would move to Washington primarily for healthcare would not be covered. The care includes, but is not limited to, everything covered under the “Essential Health Benefits” of the ACA (ambulance, out-patient and in-patient visits, emergency care, etc.), with a focus on preventative care. The coverage would be secondary to state/federal insurance plans, which I take to mean Medicare and Medicaid, or any other optional work-funded or personal insurance plans. No providers will be excluded from receiving payment from the trust (though the text does not indicate whether providers will be forced to accept patients insured through the trust). Long-term care (nursing home) coverage would not start immediately, and when it does start, a co-pay would be required from those with an income of over 150% of the federal poverty level.
The trust will be governed by a board consisting of 9 paid members, who will be reconsidered every 6 years. Both parties in the House and Senate will submit a list of 5 people they would like on the board. The governor chooses the board members, but must pick 1 person from each list. The board members must be healthcare professionals (both on the financial and administration side; the bills do not mention practitioners), business professional, and/or understand the needs of diverse populations. The board will appoint 3 unpaid committees: a financial committee, a citizen’s committee, and a professional committee. The board will manage the money in conjunction with the financial committee and develop standards of care and determine needs in conjunction with the citizen’s and business committees. Administrative costs are not to exceed 11% of the total trust amount.
The funding mechanism of trust isn’t established in the bill, and instead, the financial committee will work with the board to determine the best way to fund the trust. Suggested funding mechanisms include employer taxes, premiums for Washington residents with incomes over 200% of the federal poverty level, and/or shuffling other current tax revenues around.