Health funding in Washington State operating budget proposals

Last week, budget conversations kicked into high gear after the House and Senate Democratic caucuses released their transportation, operating, and capital budgets for the 2021-23 biennium. The budget proposals come after a better-than-expected revenue forecast which showed a $1.34 billion increase for the 2019-21 biennium and a $1.949 billion increase for the 2021-23 biennium compared to the previous forecast.

With both the House and Senate operating budgets scheduled for executive sessions on Monday afternoon, here’s where the health-related budget proposals currently stand:



House operating budget proposal:

House Democrats’ 2021-23 operating budget includes $58.3 billion in state funds, with a total of $121.2 billion when federal and other funds are factored in.

The budget bill (HB 1094) allocates a total of $18.59 billion in state funds ($53.32 billion total funds) toward health and human services expenditures. Broken down, this includes $7.25 billion to the Dept. of Social and Health Services, $6.31 billion in state funds for the Health Care Authority, and $192.7 million in state funds for the Department of Health.

According to a statement from House Democrats, health budget items include $94 million for primary care provider rate increases, $100 million for local public health districts and regions, and $35 million for uninsured and underinsured care through Federally Qualified Health Centers, rural health clinics, and free clinics.

Related to the pandemic, the two-year budget includes $1.185 billion in American Rescue Plan Act funding for COVID-19 vaccines, contact tracing, and testing.

Strengthening the state safety net is another priority of the House budget. Among these budget items is $1.07 billion for rental assistance, $140.8 million for food assistance programs, $121.6 million toward housing and homelessness assistance, and $63.63 million to increase Temporary Assistance for Needy Families (TANF) grants and extend benefits.

The budget also allocates funding toward health equity initiatives including $340 million for immigrant relief funds.

Behavioral health is highlighted in the budget proposal with $96.7 million slated to fund bends with community-based providers. This funding is meant to fund beds to replace the wards closed at Western State Hospital. Other behavioral health funding includes $90 million to improve Washington’s suicide and behavioral health crisis response system, and $69.38 million for substance use disorder treatment and response.

The House budget bill is scheduled for executive session in the Appropriations Committee on Monday at 1:30pm.


Senate operating budget proposal:

On Thursday, Senate Democrats proposed a two-year, $59.2 billion spending plan. When combined with federal funds, the proposed budget totals $119.4 billion.

In total, the budget allocates $7.27 billion in state funds ($16.8 billion total) for the Dept. of Social & Health Services, $177.6 million in state funds for the Department of Health, $2.1 billion for the Dept. of Children, Youth, and Families, and $6.4 billion for the Health Care Authority.

The Senate budget includes $1 billion in federal funds to support COVID-19 vaccination, testing, and tracing efforts; $850 million in federal funds for housing and homelessness; $209 million to address health care affordability through outreach, premium assistance, and customer assistance; $150 million for Foundational Public Health Services; and $101 million to increase community behavioral health services.

The Senate budget overview highlights significant savings items such as $617 million in state savings from the increased federal match for Medicaid services brought on by the pandemic, and $76 million in state savings from a reduced number of wards at state psychiatric hospitals.

The Senate budget bill is also scheduled for executive session on Monday at 1:30pm in the Senate Ways & Means Committee.