Q&A: Rep. Eileen Cody reflects on the 2019 legislative session

Representative Eileen Cody represents Washington’s 34th Legislative District and is the Chair of the House Health and Wellness Committee. Cody has long been a health policy leader in Washington State’s legislature, having worked on issues such as implementation of the Affordable Care Act, mental health parity, and patient safety improvements.   

We caught up with Rep. Cody to take a look back at the 2019 session to discuss key bills passed this year, funding in the budget, and where the health policy conversation heads next in Washington.

 

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Emily Boerger: How would you sum up session this year in terms of health-related legislation?

Eileen Cody: “I thought we did very well, it was a big year. We got a lot of big bills through, and several that we’ve been working on for quite awhile. Surprise billing probably took the longest — well, and Tobacco 21. Several things that we’ve been working on for awhile made it through.”

EB: Yes, I wanted to talk about the surprise billing bill in particular. This issue has been brought forth several times in the past few years, but this year it finally passed. What did it take to finally push it through the legislature?

EC: “I think we wore everybody down. No, I think everybody, this year, realized that… it’s getting momentum across the country. And so, I think that everyone realized that they wanted to get something worked out before other states got more things done, and they didn’t like what was going on there. So it got them moving, realizing that they needed to get a resolution. And, literally, I think everybody was so tired of it that they wanted to make sure that we got it done this year, so that they didn’t have to talk about it again. Sometimes, that’s what it takes.

Figuring out how we were going to do the arbitration was one of the sticking points — including what the arbitrator could look at and all of these somewhat picky things. So, we would get close, and then there would be an argument over something that would pop up that didn’t seem as consequential, but it would turn into the biggest thing that ever happened.

But, I think that we did finally get people to a place where… Actually, some of the insurers and the doctors came to the bill signing. So, that shows that they ended up supporting it.”

EB: You mentioned surprise billing and Tobacco 21. What are some of the other bills that passed this year that you are particularly excited about?

EC: “Well, the list of the big ones of course is surprise billing, Tobacco 21, getting rid of the personal exemption on the MMR — that was a huge thing. The Long-Term Care Trust Act, the public option…

We had progress on mental health. That’s actually — we’re talking about the money we spent there — but we managed to get new facilities created and legislation there. Trying to get reciprocity for the workforce… that’s not getting that much press, but I think we did a lot of good work there. And the good thing on mental health is that with all of that, we really worked together well in a bipartisan way this year on changes for mental health, so I’m happy there.”

EB: What about the comprehensive opioid legislation?

EC: “Yes, that’s a big deal, because that was two years in the making to finally get that one passed. And that’s another one that I think we did well on.

I had gone last year — when we were first working on the opioids bill — I got to go to NCSL [National Conference of State Legislators] and go through their opioid fellowship. So, that was a lot of the stuff that got incorporated from the bill last year.

Because it was a short session [last year], when I did it, I was taking everybody’s opioid bills and we rolled it all up into one. I thought it was the best way, but it ended up dying in the Senate because they ran out of time and will. So that was a big disappointment.

I think one of the reasons why it looks like we had such a big year this year is because we had such a lousy year last year. But, all the work that we wanted to get done last year, we definitely got it done — plus more — this year. So, it certainly was a big year for us.”

EB: So the opioid legislation not passing last year, that was more a product of running out of time?

EC: “Yeah, well I always say time and will. I always think you can make time if you want it; it’s a combination. It didn’t reach the priority stage in the Senate.”

EB: What about bills that didn’t pass this year that you wish had?

EC: “Oh I can think of one… the bill that was Macri’s bill [HB 1608] that had been worked out with women’s groups and patient advocates and the hospitals about…basically lifting the gag rule from providers so that they can talk about anything, like death with dignity and abortion.

[The bill would have ensured] that the hospitals can’t keep you from discussing it if it’s within your scope of practice. We had an agreement on that bill, but it didn’t get out of the House and that was a disappointment.”

EB: What about any disappointments related to funding in the budget?

EC: “Probably the biggest thing I was upset about — because of the Senate — is the money that was cut out of the Health Care Authority.

I worry that we keep giving jobs to the Health Care Authority: They’ve got mental health, and now they’re going to have to do the bids for public option, and we keep not giving them the money.

And they’ve been having the shortfalls, which goes back [to] the Healthier Washington days, when they didn’t make the savings because we didn’t do the behavioral health integration as quickly as what they had hoped for. And the pharmacy cut from two years ago, it was in the budget. And now the managed care dental, that was another one… now we’ve totally scrapped that for this biennium.

But, all of those things, we’ve basically been balancing the budget on the money in the Health Care Authority, and we’ve done it again this year. And I have concern that we are under-funding the agency and that they’re going to have a hard time actually keeping doing everything we’ve told them that they need to do. That’s probably my biggest worry. So it’s not any one specific cut, it’s just how they did the cuts in the budget.”

EB: Looking to the future, where does the conversation in health policy head next for Washington? What are the challenges that still need to be addressed?

EC: “Well, with rural health we want to move to global budgeting in our rural hospitals because we’ve got so many that are financially strapped. It’s just — the system has to change, because it’s not like they’re ever going to make money. We’re not really in the business to make sure that they make money, either. We just need to make sure that we have a health care system for all of our citizens in the state.

So, figuring out what that’s going to look like, I think, is a big challenge. That’s what I’m going to be working on this summer — that’s what I would say is the biggest thing.”

This interview was edited for length and clarity.