5 Things Washington: “Chronic COVID,” Rx costs, Payment parity

We are now covering state health policy in 15 states, providing more independent coverage of state and market-level health care coverage than any outlet in the country, so far as we can tell. It’s a long way from our first story on Washington State health care back in 2011!

If you’d like to subscribe to our daily newsletter, you can do so here. You’ll get a morning run down of all of our coverage from across each of our states, and now federal policy too. This morning’s newsletter had 14 stories for your daily read-in. It’s a unique level of coverage that will help you get up to speed quickly on what’s happening in health reform.





With help from Emily Boerger

1. ARNP payment parity in the session

The Senate Health and Long Term Care Committee heard testimony on a bill last week which would require health carriers to reimburse advanced registered nurse practitioners (ARNPs) at the same rate as physicians for the same services. Louise Kaplan, with ARNPs United of Washington State, testified that in recent years, some health insurers reduced reimbursement to ARNPs to 85% of the physician fee schedule.

Sen. Emily Randall, chief sponsor of the bill, says this disparity could limit access to care while others testified that it was discriminatory. Following our coverage of the bill’s public hearing, Physicians for Patient Protection offered their take on the bill in this op-ed, saying “With the cost of additional years of education, higher licensing fees, board certification fees, and continuing education, physicians pay far more than nurse practitioners for the right to practice medicine.”


2. Implications of “chronic COVID”

Last week I had the opportunity to speak with Dr. Chris Murray, Executive Director of the Institute for Health Metrics and Evaluations (IHME), where I learned something I didn’t know. Based on newly released data from the Novavax COVID vaccine trial, being previously sick with COVID-19 appears to offer no protection from being infected with the new South African strain of the virus.

Without cross-variant immunity, Murray says this data indicates we may be moving to a “world of chronic COVID” where every winter we treat COVID as we do the flu. I outline three immediate things that will change for us in this column. Perhaps the most important is this: hospitals and their current financing models are in trouble. Video of my full conversation with Murray is available here.

3. MacCaul discusses “double pandemic”

During a recent conversation with Reporter Michael Goldberg, AARP Washington State Advocacy Director Cathy MacCaul discussed the “double pandemic” facing seniors and offered her take on what Washington’s long-term care system does right and where it needs improvement. She also discussed HB 1218, a bill that would require long-term care facilities to develop comprehensive disaster preparedness plans and ensure residents are able to access communication devices.

HB 1218 was one of several bills discussed during a recent House Health Care and Wellness Committee meeting which also covered implementation of the 988 crisis response system and security protections for COVID-related health data. The bill is scheduled for executive session this Wednesday.


4. Update on drug pricing bills

On Friday lawmakers passed out of committee a bill sponsored by Sen. Kevin Van De Wege that would authorize the HCA to partner with other states, agencies, or nonprofit entities to produce, distribute, or purchase generic drugs. The bill, which passed with 7 votes on the 12 member committee, would require state-purchased health insurance programs to purchase generic drugs though the partnership.

The bill would also, depending on availability, allow local governments, health carriers, and private entities to purchase generic drugs from the HCA. Sen. Karen Keiser’s bill, which would assess a tax on unsupported prescription drug price increases, was heard in committee two weeks ago but has yet to move forward.

5. What the data says about us

Recent US economic data shows 2020 was the worst year for economic growth since 1946. In Washington, 57.9% of 4.9m responding to a recent survey said they felt “down, depressed or hopeless” at least “several days” in the last week. 10.1% of Washingtonians received “counseling or therapy from a mental health professional” in the last seven days. However, another 12.3% said they “Needed counseling or therapy from a mental health professional, but did not get it for any reason.”

Of those responding, 10.7% said they were in households with children where “sometimes” or “often” there was not enough food to eat. Of those yet to receive the first dose of the vaccine, 17.4% say they may not get it at all, and 7.9% of those say they will “definitely not get a vaccine.” Another 14.4% say simply they “Don’t believe I need a vaccine.”