Washington’s Universal Health Care Commission identifies framework for establishing equity


Shane Ersland


Washington’s Universal Health Care Commission has identified a framework for establishing equity as members consider options for implementing a healthcare coverage system for all residents.

The commission was created with the passage of Senate Bill 5399 in 2021 to make healthcare more accessible and affordable for residents. Members voted to implement an equity framework in developing a universal healthcare system during their meeting on Tuesday.


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Dr. Quyen Huynh, health equity director for the Washington Health Care Authority (HCA), presented HCA’s health equity toolkit to members during the meeting. The toolkit helps HCA apply a health equity lens to its job functions, policies, programs, and services, Huynh said. It also helps staff identify and address health disparities in its work, including legislative bill analysis.

Huynh discussed some of the things the equity toolkit has helped the HCA accomplish since it was implemented in 2021. HCA hired a health equity director, launched the Collaborative Community for Health Equity, and implemented the health equity liaison role and liaison committees in 2021. In 2022, it created a health equity video for nurse leaders in partnership with the Washington Center for Nursing and created the Pro-Equity Anti-Racism community advisory team to hear from community members about how HCA’s services/programs impact them.

HCA’s health equity lens tool helps staff:

  • Identify potential unintended health impacts (positive or negative) of a planned action, program, or policy on the people it serves.
  • Develop recommendations to mitigate negative outcomes and maximize positive outcomes on the health of people who experience health inequities.
  • Embed equity across HCA’s existing and prospective decision-making models so that it reflects its core values.
  • Support equity-based improvements in its programs, service designs, or resource allocations.
  • Raise awareness about health equity as a catalyst for change throughout the organization.

“Every time you make a decision on something, I ask that you consider this equity lens,” Huynh said.

Commission members voted to implement the health equity toolkit in its universal health system development efforts. Commissioner Joan Altman, director of government affairs and strategic partnerships at the Health Benefit Exchange, said it is similar to the health equity framework the exchange uses.

“This looks very consistent and familiar,” Altman said.

Commissioners also discussed incorporating Senate Bill 5335, which is currently in recess in the legislature, in their work. The bill would create a nonprofit health financing entity called the Washington Health Trust. The bill called for the trust to ensure all Washingtonians could enroll in nonprofit health insurance coverage without the burden of premiums, deductibles, copayments, or medical bills. SB 5335 has not seen any legislative action since its first reading in the Senate Health and Long Term Care Committee on Jan. 12th.

SB 5335 became the primary initiative Whole Washington, a grassroots organization advocating for a universal healthcare system in the state, advocated for during the legislative session. Whole Washington will provide an overview of the bill during the commission’s August meeting. That meeting could be a big step for the organization, as Whole Washington Campaign Director Andre Stackhouse told State of Reform that he wants to develop a closer relationship with the commission in April.

The commission provides regular reports to the legislature, and beginning in 2025, each report will summarize how SB 5335 would help the commission address key components in its plans.