24-24 tie in Senate | Murray, Cantwell, Price | Dawn Johnson

I sometimes think that things might be relatively straightforward in health care – and January was one of those times.  Yet… not so much. From commercial insurance to Medicaid policy, there are so many variables in flux that even looking ahead to April is a task.

So, here are 5 Things We’re Watching that we think are key to watch, regardless of where the policy and marketplace take us.


1.  BHO proposal to forestall integration

At a recent behavioral health organization (BHO) meeting of administrators and providers across the state, a proposal was sent around outlining the scope for a common lobbying action.  There was also some apprehension about Gov. Inslee’s plan to move DBHR into the HCA.

I don’t see this proposal among the more than 1400 bills dropped so far.  If it does become a bill, I don’t see a legislative champion now that Sen. Hargrove has retired. And, if one arises, I don’t see the votes to overcome a veto by Gov. Inslee. It’s early but things move very quickly in Olympia, and time is passing for this proposal to get legs.


2.  State employee TPA services out for bid

The HCA is out with its RFP for TPA services for public employees, a contract Regence currently manages. A number of health plans will submit bids, but we’re hearing there may be some new names pitching the work including out of state plans that don’t have a footprint here otherwise.

The roughly 362,000 lives in the overall program represent a significant population for the successful respondent, though it may come with little margin. These contracts are often less about making money, and more about having increased leverage over provider rates.


3.  Video: Dawn Johnson on leading during a period of transition

“The federal government sets the pace,” says Dawn Johnson, EVP at COPE Health Solutions. But when the feds are shifting their focus, it’s important for states to be willing to continue their path towards innovation. That’s the point of her comments in this edition of “What They’re Watching.”

“Understand what the needs are of your providers and your population, and make that plan.  That will always align with what the federal government wants to do,” she says.  That’s probably sage counsel during this time of transition.


4. 24-24 tie in state Senate; “working” majority?

State Senator Brian Dansel (R-Republic) has resigned to take a position in the Trump administration. While the position will get filled in time with another Republican, for the time being the Senate is dead-locked with 24 Republican caucus members (including Democrat Tim Sheldon) and 24 Democratic caucus members.

With Sen. Doug Ericksen also getting a short-term position with the Trump administration, thus necessitating his flying back and forth to DC, this means the Senate Republicans will have 23 votes instead of the needed 25 to manage the chamber. That could become a challenge when the March 8th legislation cutoff draws closer and legislation needs to move off the floor of the Senate to the House.


5.  Cantwell and Murray on Tom Price

Sen. Murray was understated but on point in the Senate HELP Committee hearing on Tom Price’s HHS nomination, as in this clip. She didn’t get named in the headlines as others did, but as the ranking member on the HELP Committee, it was Murray who drove much of the latest news cycle on Price. As an aside, she also earned the title of “politician who should make you feel good about politics.”

During the Senate Finance Commitee hearing, Cantwell questioned Price on Medicaid, the long term care system, and – yes – the Basic Health Plan she championed in the ACA.  You can watch Price’s answers here.  Cantwell also voiced an emphatic ‘no’ vote on ACA repeal when Senate Democrats staged something of a protest (at least by Senate standards of decorum).