Washington lawmakers’ health priorities will focus on unfinished business from 2023 during short session


Shane Ersland


Washington lawmakers will only have 60 days to pass legislation during the 2024 session, which began Monday. Members of the Senate and House discussed health priorities they hope to address during the short session at the 2024 Washington State of Reform Health Policy Conference last week.

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Sen. Annette Cleveland (D-Vancouver), chair of the Senate Health and Long Term Care Committee, said the chamber will likely focus on legislation that did not get passed during the 2023 session—which convened for more than four months—rather than new bills.

“The focus is most certainly going to be on completing work that maybe we weren’t able to finish last year, rather than trying to tackle any new policy issues,” Cleveland said. “There’s always an exception or two.”

Rep. Nicole Macri (D-Seattle), vice chair of the House Appropriations Committee and member of the House Health Care and Wellness Committee, said the House’s approach to the 2024 session will be similar.

“It is going to be incredibly short. Thinking about what bills we can realistically get through, we have a few weeks in January for house-of-origin bills to get heard and move through the process. But when we pass those over to each chamber and switch sides, there are very few hearings and opportunities to move bills through committee. So we’re going to get real strategic about the bills we’re going to be able to pass through and over to the governor’s desk. So, as we often do in the second year of a biennium, we’ll be building on the work we did last year.”

— Macri

Cleveland, Macri, and Sen. Ron Muzzall (R-Oak Harbor)—assistant ranking member of the Senate Health and Long Term Care Committee—all identified behavioral health as a priority for the session. 

“Post-pandemic, we have a real problem with access to behavioral health and substance abuse treatment,” Muzzall said. “I’m maybe a little more passionate about that, having buried my niece in May as a result of a substance abuse issue. I’m also a little preachy about treating the demon that is addiction. We spend too much time talking about the individual, and not enough about the demon that has taken over their lives.”

Muzzall said he will continue to support bills that support behavioral health and substance abuse treatment. 

“And the overarching part of that is that we will be dealing with homelessness at the same time, because it’s certainly one of the greater causes,” he said. 

Cleveland said the state has an opportunity to learn from the effects the pandemic had on the healthcare industry, and work to build a stronger, more resilient healthcare system for the future. 

“In addition to that, as many sectors are facing workforce shortages, we are facing workforce challenges within healthcare and behavioral health,” Cleveland said. “In the Senate Democratic Caucus, we continue to make access to reproductive healthcare a top priority.”

While many Republicans are outspoken in their opposition to abortion, Muzzall said the availability of reproductive services is a reality in Washington.

“As far as access to abortion, the reality is it’s the law in this state. As I see it, it is truthfully a question that has been answered. And in reality, if we start looking at it in other countries where it’s illegal, it still exists. So my goal is to see if we have safe, available reproductive healthcare. It isn’t a question in my mind, though (I’m) a Republican. I deal in the world of reality.” 

— Muzzall

Healthcare affordability will be a top priority for Macri. She said healthcare costs continue to rise at a rate that is unsustainable for constituents. 

“We are seeing really big costs impacting our patients and our employers, especially small businesses,” Macri said. “So we’ll continue to work on affordability strategies related to healthcare. We’re going to have to look at how we do this work differently. Changing the way we do business is hard for all of us.”

Macri worked closely on the implementation of the new Washington Cares Fund—which provides working Washingtonians with a way to earn access to long-term care benefits that will be available when they need them—which she highlighted as a positive example of reforming healthcare operations.

“I’ve been really involved in the implementation of the long-term care social insurance program that Washington was the first to stand up,” she said. “It will be an issue of great conversation statewide. It’s an example of how we’re trying to change the way we do things in Washington that will not only improve the quality of life for people, but will reduce costs for families.” 

Macri will also be keeping tabs on the state’s Medicaid redeterminations process. Washington began its process in April, and there is an expectation that the state could potentially end up disenrolling 560,000 Medicaid enrollees.

“We expanded Apple Health coverage [last year]. It’s the largest expansion of Apple Health coverage since the Affordable Care Act. But at the same time, we are continuing to work through the (public health emergency) redeterminations. So we continue to track access to care for our most vulnerable residents. We’ll continue to work in these areas this session.”

— Macri

Cleveland said her top priority will be pushing Senate Bill 5481 (the uniform telehealth act), which would allow for circumstances in which an out-of-state healthcare provider could provide telemedicine services to patients in Washington. 

“We know technology continues to move at a lightning-fast pace,” Cleveland said. “And we have to ensure we’re doing all we can as a state to ensure patients who need that service have access to it. That’s my top priority for this particular session.”

Muzzall said Washington was fortunate to have made progress on telehealth access when the pandemic began.

“When we were working on telehealth in 2020, we had no idea how fortunate we were to be ahead of the curve,” he said. “Since the pandemic, our percentages of patients using telehealth have declined significantly. However, there are different areas where it is still incredibly important. One of them is behavioral health. Telehealth and audio health are incredibly important for individuals who are seeking treatment.”

Muzzall said he will focus on improving access to fentanyl test strips—as he did during the 2023 session—as well as Medicaid reimbursement reform.

“Our Medicaid system in the state, when it comes to reimbursements, ranks in the bottom of the US in many areas,” he said. “And unless we’re willing to spend the money, we’re not going to see a way forward when it comes to providing access. So I will have several bills on that. We now have one out of four citizens in Washington that are on some sort of state-supported healthcare; 800,000 on Medicaid (and) 1.2 million on the state healthcare program. We’ve made a commitment and we need to live up to that.”

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