The Legislature adjourned Sunday after an active session for health care. The most important takeaway today is that a new payroll tax arrives in January and will take 58 cents of every $100 a worker makes to fund a state-run, socialist-style, long-term care program lawmakers passed in 2019. Rules are still in the works, and definitions and directions are not clearly laid out, causing some confusion, but what is clear is that a bill passed this legislative session further limiting the time Washingtonians have to opt out of this tax grab and make their own choices about long-term care needs.
There isn’t a lot of time to unwrap this gift from the Legislature. Washington workers need to have qualifying long-term care coverage in place by November 1st, if they hope to then apply for an exemption. If they don’t get one, the tax collected will provide residents who retire here and who pay in long enough access to an insufficient, not portable, one-size-fits-all benefit for long-term care needs. A private long-term health insurance plan can outdo this government one for many of the people paying hundreds of dollars for a new tax every year.
I’ll be writing more about how workers’ paychecks will suffer as we continue to unwrap this ugly sweater, but this tweak made to the 2019 long-term care law means workers need to act now. Buying long-term care insurance is not like securing auto insurance. It’s complicated.
Some progress on patient access to telemedicine
A decent legislative gift did arrive in a few bills that put patients first and eliminated some hurdles blocking telehealth. SSB 5423 allows a licensed out-of-state practitioner to consult through telemedicine with a practitioner licensed in Washington about the diagnosis or treatment of a patient. That’s cheer-worthy. Another bill, ESHB 1196, expands telemedicine reimbursement to include audio-only telemedicine. The law will help people living in rural areas, people with limited transportation and those who would rather talk to a doctor than use online services for their health needs.
Washington Policy Center has long-been a proponent of eliminating unnecessary regulations. In regard to telemedicine, we've wanted to see this kind of access for Washingtonians. As Senior Fellow Dr. Roger Stark, MD, told The Lens in 2016, “In central and eastern Washington, especially in smaller communities where they’re miles away from the nearest clinic or nearest provider, we see telemedicine as … a great asset in taking care of these people and delivering health care.” Increasing access to this kind of care was one of our 2020 Policy Guide recommendations. Covid-19 brought more awareness to how helpful telemedicine can be and seems to have helped our deregulation wishes along.
Bills that died
Early on during this legislative session we expressed concern about a misguided tax on health insurers and a bill that would essentially put price controls on prescription drugs. We also wrote and testified on a statewide sweetened beverage tax, based on a Seattle law. It was full of good intentions but short on substantiated health benefits. It also would have threatened jobs, created cross-border shopping, financially impacted those it was trying to help and possibly created vice substitution.
These bills and taxes stalled and died quietly. Victory — for now.
Socialized health care receives more energy
Another big dissapointment came as the majority in the Legislature continued to show its desire for a socialized health-care system in Washington state. E2SSB 5339 creates another commission to seek ways to ban private health care and impose socialized medicine on Washingtonians, abandoning the innovation and choice that a free-market system can provide.
Universal health care has not proven able to deliver low costs, which is why there have been multiple commissions exploring the switch to such a system. Universal care has delivered lower-quality care and service rationing in places that have adopted it. Quality, affordability and socialized health care don’t go together.
Knowing this, and perhaps due to criticism like ours that these commissions are set up to fail, this new commission will be an ongoing one with no end date or expectation of finding a way to fund universal health care. The group’s job is simply to pave the road for socialized care and its unmet promises.
We’ll keep our eyes on this commission, as well as an initiative that seeks to bring universal care to Washington. Initiative-organizer Whole Washington has a kick-off event already planned this week, disappointed that the Legislature didn't promise more.
Missed opportunity in nurse licensure
The state Legislature has ignored lawmaker efforts and our recommendation in 2020 to bring Washington into the Nurse Licensure Compact (NLC). It did so again this session. The Senate Health and Long-Term Care Committee did have a valuable work session about it two weeks ago, however. Modeled after the nation’s Driver License Compact, the NLC allows nurses to go where they’re needed and does away with an interstate ban that is burdensome for many nurses and hinders the well-being of patients.
Almost every single state, including ours, issued some sort of a licensure exemption during these Covid-19 times to allow nurses to come into a state and practice as quickly as possible. Makes sense, right?
This should be regular practice in Washington. We’ll focus on this common-sense solution that puts patients first in the off-session.