5 Things Washington: Medicaid redetermination, COVID-19 treatment costs, Women & children’s health report


Emily Boerger


We’ve been hard at work putting together the Topical Agenda for the 2022 Washington State of Reform Health Policy Conference coming up on January 6. We’ll announce that agenda in the coming weeks, but if you already know that you want to join us, be sure to take advantage of the Early Bird registration pricing.

These discounted rates end on Friday, so now is the time to sign up if you’d like to save a few bucks! We’d be honored to have you with us.

Emily Boerger
Managing Editor
State of Reform


1. Preparation for Medicaid re-determination

State leaders are preparing for the impending end of the federal public health emergency declaration, which will instigate a lengthy eligibility redetermination process for Washingtonians who currently benefit from Medicaid. Since March 2020, 300,000 new individuals have enrolled in the program, but the Health Care Authority tells State of Reform that it’s unclear how many will face disenrollment. A recent study from the Urban Institute found that 15 million people across the US are at risk of being disenrolled.

These are issues that Sen. Annette Cleveland, chair of the Senate Health and Long Term Care Committee, is focused on. She says the state is exploring ways to make the transition seamless for people who will be disenrolled, including potentially renewing coverage for a year or providing people with adequate advanced notice.


2. Video: The future of gene therapy

Bhash Parasuraman, vice president of value and access for rare disease and internal medicine at Pfizer, joined State of Reform last week for a conversation on the future of gene therapy. As part of our virtual “Leadership Series,” Parasuraman discussed the policies she’d like to see to support these treatments, barriers to access, and the outlook for the road ahead.

When asked about some of the policymaking that needs to take place to better support gene therapies, Parasuraman said it’s important to look at innovative payment models because unlike most medicines today, gene therapies are one-time treatments. “These are going to be more expensive and that’s going to create some budget challenges, particularly for Medicaid … There needs to be mechanisms or policy changes in place to allow for different payment models.”

For more on this topic, we also recently hosted a “5 Slides” conversation on gene therapy and its promise for rare diseases, which you can view here.


3. Compounding disasters and behavioral health

At the start of the pandemic, we highlighted this chart, which shows the typical reactions and behavioral health symptoms seen in disasters like the worldwide COVID-19 outbreak. Following a brief honeymoon period, the chart predicted a rapid emotional decline which would take over a year to recover from. At a recent House Children, Youth & Families Committee meeting, state leaders discussed what the chart looks like when a secondary disaster hits – like a major wildfire or the Delta surge.

Early in the summer, with widespread availability of the vaccine, there was hope that the worst of the pandemic was behind us. But the Delta surge caused emotional and mental health gains to regress and created a “disaster cascade,” says Dr. Tona McGuire, co-lead of DOH’s Behavioral Health Strike Team. She says a secondary drop in mental wellbeing will especially be seen among those struggling financially, racial and cultural groups disproportionately impacted by the pandemic, children, students, and health care workers.

4. COVID hospital and treatments costs in WA

Levels of COVID transmission in Washington State have been declining since early September, but levels are still high, leading health officials to predict hospital rates will continue to be elevated into winter. Last week, FAIR Health released a set of interactive maps showing typical costs for COVID treatment and hospitalizations. The data, which evaluates out-of-network and in-network charges, shows Washington State with some of the highest rates in the country on some measures.

For COVID-19 complex inpatient treatment, the average out-of-network charge in Washington is over $334,000, making it the 11th most expensive state to receive such care. For in-network charges for complex inpatient treatment, the average allowed amount in Washington is about $108,000. Washington’s profile, which also includes cost data on outpatient treatment and noncomplex inpatient treatment, is available here.

5. Mixed results in women and children health report

Washington earned high marks for its low infant mortality rate, high prevalence of food sufficiency among children, and comparatively low rates of poverty in America’s Health Rankings’ new 2021 Health of Women and Children Report. The report offers a state-by-state comparison on a series of social, economic, behavioral, and clinical factors.

Health challenges identified in the report include: low high school graduation rates and graduation racial disparity (WA ranks 42nd), high prevalence of students experiencing homelessness (43rd), and low percentages of early and adequate prenatal care (41st). Washington also ranks 44th in the country for youth illicit drug use and 44th for rates of anxiety. State of Reform Reporter Aaron Kunkler has coverage of the full report here.