5 Things Washington: Health in the budget, Health policy recap, Cost of care


Emily Boerger


Today marks the final day of the 2022 legislative session. Despite it being a short session, lawmakers were able to pass several pieces of meaningful health-related legislation.

In this edition of “5 Things We’re Watching,” we look back at the session through a deep dive into health funding in the supplemental operating budget, and a roundup of health bills that passed both chambers.

Emily Boerger
State of Reform


1. Health in the supplemental budget

Lawmakers are set to vote on a $64.1 billion supplemental operating budget later today after the Senate and House Democrats released their negotiated proposal on Wednesday. In this piece, State of Reform reporter Nicole Pasia highlights health-related funding in the budget including the $351 million slated for vender rate increases for those providing services to individuals with developmental disabilities or with long-term care needs.

Also included in the budget is $90 million to address physical and social emotional needs of K-12 students, $50 million to expand access to broadband, and $46 million for health care workforce training initiatives. To address a state-wide behavioral health workforce shortage, the budget allocates $100 million from the Coronavirus State Fiscal Recovery Fund for one-time payments to community-based, Medicaid-contracting providers.

2. Health policy recap

Lawmakers passed a broad range of health policy this year covering topics spanning from prescription drug affordability to balanced billing and abortion law. Among this year’s legislation that made it through both chambers is SB 5532, which would establish a prescription drug affordability board, HB 1866, which creates the Apple Health and Homes Program, and SB 5644, which supports training opportunities for co-response teams.

In the past week, a bill that would require the Washington State Patrol to establish a Missing Indigenous Person Alert designation passed unanimously in both chambers. And on Friday, Gov. Inslee signed SB 5546, which would cap out-of-pocket insulin costs at $35 per month, and HB 1286, which adopts the Psychology Interjurisdictional Compact in Washington.


3. APCD data offers insight into health care costs

Utilizing data from Washington’s All-Payer Claims Database, the OIC recently released a report which found that the commercially insured population saw a 13% increase in per member per month spending between 2016 and 2019. During this time, medical costs grew 11.5% and pharmacy costs increased by 19.2%. The report identifies pharmacy, acute inpatient care, outpatient emergency and non-emergency care, and ambulance services as the highest cost drivers.

The Washington Health Alliance also recently released a report on health care costs that offers a statewide comparison of PMPM spending for each county and ACH in the state. The report finds that in 2020, Okanogan, Whatcom, Chelan, and Clallam Counties had the highest commercial PMPM spending. This shifts when looking at Medicaid spending where Island, Jefferson, and Klickitat saw the highest PMPM spending.

4. DelBene leads effort to encourage value-based care

Rep. Suzan DelBene led a group of over 40 members of Congress in sending a letter on Tuesday to HHS Secretary Xavier Becerra calling for new incentives to encourage more providers to participate in value-based payment models. The letter states: “Achieving the goal of all Medicare beneficiaries and most Medicaid beneficiaries in a relationship with accountability for quality and total cost of care by 2030 will ensure that beneficiaries are receiving innovative, high quality care at a lower cost.”

The letter specifically calls on CMS to adopt policies that would improve participation in the Medicare Shared Savings Program and other Innovation Center programs through modifications to performance metrics, addressing overlap between VBC programs, and better support for accountable care organization participants. Rep. DelBene is a co-sponsor of the Value in Health Care Act—a bill that also aims to accelerate the move to value-based care.


5. WA to receive $183 million to address opioid crisis

Attorney General Bob Ferguson announced last week that Washington will receive an additional $113 million from the Sackler family and Purdue Pharma after challenging Purdue’s bankruptcy plan. The additional funds bring Washington’s share to $183 million, which will be used to help the state, cities, and tribes respond to the opioid crisis.

A recent UW survey of 1,000 individuals who use syringe-service programs in the state found that 42% of respondents had used fentanyl in the previous three months—that’s up from 18% in 2019. Lawmakers this year passed legislation to help address the state’s opioid crisis by allowing nurses to dispense overdose reversal medications out of the ED.