Insurance

The $31.4 billion general operations budget approved by the legislature filled a $9 billion shortfall with federal stimulus money, one-time transfers and more than $4 billion in cuts to education, health and state programs. The budget includes many cuts to health care and education and slashes $1028 billion from state employee salaries, health benefits, and other compensation, resulting in 7,000 to 8,000 lost government and public school jobs. The state's K-12 system will lose $800 million in state funds, although about half of that figure will be made up by federal stimulus aid going directly to school districts. While higher ed money has been cut as well, the state has authorized two and four year institutions to shift the burden to students by raising tuition by 7% to 14%. The $7.5 billion transportation plan, however, passed with only 8 senators voting "nay" and is projected to create 49,000 jobs. The bill puts $4 billion into more than 400 road projects over the next two years.

With no state income tax and a regressive, sales-tax-dependent tax structure, revenue generation for state and local governments is a perennial hot topic in Washington State. Lawmakers considered but failed to act on a proposal to create an income tax for the state's top earners, those earning more than $500,000. Tax fairness proponents plan to renew the effort as part of a broader campaign to improve the state's tax structure in subsequent years. Still, lawmakers approved SB 5433, which gives local governments, in particular, a little more flexibility in raising revenue. In most cases, the bill requires officials to gain local voter approval for any levy or fee increases. One positive provision allows King County, which includes Seattle, to add a 7.5 cent property tax for transit projects.

At the last minute, lawmakers passed SB 5963, sponsored by Sen. Jeanne Kohl-Welles, to give employers a tax break on the premiums they pay into the state's unemployment insurance system. Earlier in the session, legislators passed HB1906, which increases jobless benefits to $225 per week through the end of the year.

Health Care: This year, lawmakers sought to preserve the state's health infrastructure so that temporary cuts to programs in eligibility and reimbursement levels can be quickly restored when the state's budget condition improves.

• Painful Cuts: $2 billion in federal stimulus funding helped the state to minimize cuts to the Medicaid program, but services for adults were curtailed and reimbursements to providers were reduced. Full implementation of a voter-approved initiative to increase training for long-term care workers was delayed a year. In response to the state's budget woes, lawmakers approved a $225 million cut to the Basic Health Plan, which serves 102,000 low-income residents and provides subsidized health benefits. As a result of the cuts, 40,000 residents will lose coverage by the end of the year. The state is currently seeking advice from advocates on how to implement the cuts.
• Covering Kids: Despite harmful cuts in eligibility and reimbursement to many programs, lawmakers were able to preserve a prior commitment to achieve health care for all kids and place the state on the path to health-care-for-all within 5 years. Lawmakers passed HB 2128, sponsored by Rep. Larry Seaquist, to confirm the state's goal of ensuring all kids have health coverage by 2010. The measure officially named the state's kids program, Apple Health for Kids. Its new provisions streamline enrollment measures (of the 75,000 uninsured children in WA, almost half are eligible but don't know it), take advantage of the federal re-authorization of the State Children's Health Insurance Program, and modify some requirements for a twin program that will start by 2010 allowing families above 300% of poverty to buy Apple Health coverage for their children. While families below 300% of poverty will pay relatively low-cost sliding scale premiums for the program, there was concern that the level of benefits would have made the program too expensive for parents above 300%, so the required benefits have been pared down for higher income families that may elect to buy into the program.
• A Reform Commission for Universal Care: In addition to moving forward on kids' care, Washington lawmakers committed to achieve health care for all Washingtonians by 2014 by passing SB 5945. Sponsored by Sen. Karen Keiser, the measure creates a reform advisory group to further study and develop health care reform legislation and it articulates key priorities for reform, including the choice of public or private health plans. Additionally, the bill directs the new reform advisory group to monitor state and federal progress towards health care reform and to specifically collaborate with federal lawmakers. The bill also directs the state to seek a Medicaid waiver to expand eligibility to low-income adults.
• Promoting Efficiency: Other notable health care achievements in 2009 include the Health Efficiencies Act (SB 5346), which will bring providers together to define uniform administrative standards and procedures around claims reimbursement, prior authorization and other utilization systems, and establishing a standardized and electronic process to verify patients' insurance eligibility and coverage. As Sen. Keiser notes, 30 cents of every health care dollar is spent on administration, "this legislation is intended to change that." SB 5501 will bring stakeholders together to develop processes for the safe and secure exchange of clinical data and improve patients' access to and control of their health care information.
• Other Bills: SB 5360 creates a grant program to help community-based coalitions serve uninsured and under-insured adults and children. SB 5892 will promote use of generic medications by state programs while ensuring patients' quality of care and use of quality drugs. HB 2105 creates a work group to create guidelines for the appropriate use of diagnostic imaging, like MRIs and CAT scans, to ensure these costly services are used when necessary. SB 5891 will test primary care medical home reimbursement pilot projects. And, to improve hospital safety, lawmakers passed two bills to beef up requirements on hospitals to publicly report medical errors and to conduct unannounced inspection of hospitals (HB 1123, HB1021). A key goal of the measures is to reduce hospital-based infections, notably staph, or MRSA, which can be prevalent in hospitals.

National Popular Vote: Washington became the 5th state to join the "electoral college pact" by enacting SB 5599 to commit the state's 61 electoral college votes for president to the winner of the national popular vote. Even though 77% of Washingtonians support national popular vote, opponents to the new law are waging a campaign to put the question to the voters in November.

Broadband: Awaiting action from the Governor, HB 1701 aims to bring new high-speed Internet access to residents, businesses, educational institutions, public health and safety services, and community organizations in under-served parts of Washington State, as well as increase broadband adoption throughout the state.

Gay and Lesbian Rights: Opponents of recognizing same-sex relationships plan to file a referendum today that repeals the latest addition of rights to the state domestic partners registry. The Legislature passed Senate Bill 5688, which substantially expands the registry to include all state rights accorded to married couples. The registry has more than 5,000 couples, most are same sex couples though some are heterosexual domestic partners.

Foster Parenting: Lawmakers enacted several bills to strengthen foster parents' rights and assure the best interests of children in the state's foster system. To create more stability for foster children, lawmakers passed HB 1782 to allow the courts to consider long absences by biological parents when deciding whether to end visitation rights and SB 5431 requires that children who are removed from their biological parents for a second time be placed with foster parents they know. Another bill, SB 5803, puts foster families on notice that if an adopted foster child needs mental health services in the future, the state will not pay for the care through the foster system. Such transparency is important, but advocates are hoping to get the state to someday pay for mental health services for adopted foster children, who often need such services because of high instances of abuse or drug use by their biological parents.

Newspaper Industry: HB 2122 provides the state's struggling newspaper industry with a temporary break on the state's main business tax. Under the proposed measure, the business and occupation tax on newspapers would be cut by 40 % through 2015.